convenio	data_pagamento	numero_protocolo	matricula	nome	numero_guia	ng_prest	senha_guia	codigo_produto	descricao_produto	valor_apresentado	valor_pago	valor_glosa	descricao_motivo	codigo_motivo
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12647284040	NULL	12647284040	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1750	0.0050	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	dd486d36a88cfef0b44fe652638a0164	DELFINA	12660326244	NULL	12660326244	00487	RANITIDINA 25 MG/ML 2 ML SI IM IV AP	0.0000	0.9300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	dd486d36a88cfef0b44fe652638a0164	DELFINA	12660326244	NULL	12660326244	00487	RANITIDINA 25 MG/ML 2 ML SI IM IV AP	0.0000	0.9300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	dd486d36a88cfef0b44fe652638a0164	DELFINA	12660326244	NULL	12660326244	00487	RANITIDINA 25 MG/ML 2 ML SI IM IV AP	0.0000	0.9300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	dd486d36a88cfef0b44fe652638a0164	DELFINA	12660326244	NULL	12660326244	00487	RANITIDINA 25 MG/ML 2 ML SI IM IV AP	0.0000	0.9300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	dd486d36a88cfef0b44fe652638a0164	DELFINA	12660326244	NULL	12660326244	00406	FUROSEMIDA 10 MG/ML 2 ML SI IM IV AP	0.0000	1.2000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	dd486d36a88cfef0b44fe652638a0164	DELFINA	12660326244	NULL	12660326244	00406	FUROSEMIDA 10 MG/ML 2 ML SI IM IV AP	0.0000	0.6000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	dd486d36a88cfef0b44fe652638a0164	DELFINA	12660326244	NULL	12660326244	03280	CLOREXIDINA 2 % ST TP ML	0.0000	0.8000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	dd486d36a88cfef0b44fe652638a0164	DELFINA	12660326244	NULL	12660326244	14191	OMEPRAZOL 20 MG CA VO UN	0.0000	0.9000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	dd486d36a88cfef0b44fe652638a0164	DELFINA	12660326244	NULL	12660326244	14191	OMEPRAZOL 20 MG CA VO UN	0.0000	0.9000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	dd486d36a88cfef0b44fe652638a0164	DELFINA	12660326244	NULL	12660326244	14191	OMEPRAZOL 20 MG CA VO UN	0.0000	0.9000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	24571	CLINDAMICINA 600 MG 4 ML SI IM IV AP	0.0000	13.0800	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	24571	CLINDAMICINA 600 MG 4 ML SI IM IV AP	0.0000	13.0800	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	24571	CLINDAMICINA 600 MG 4 ML SI IM IV AP	0.0000	13.0800	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	24571	CLINDAMICINA 600 MG 4 ML SI IM IV AP	0.0000	13.0800	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	24571	CLINDAMICINA 600 MG 4 ML SI IM IV AP	0.0000	13.0800	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	24571	CLINDAMICINA 600 MG 4 ML SI IM IV AP	0.0000	13.0800	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	24571	CLINDAMICINA 600 MG 4 ML SI IM IV AP	0.0000	13.0800	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	24571	CLINDAMICINA 600 MG 4 ML SI IM IV AP	0.0000	13.0800	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	24571	CLINDAMICINA 600 MG 4 ML SI IM IV AP	0.0000	13.0800	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	24571	CLINDAMICINA 600 MG 4 ML SI IM IV AP	0.0000	13.0800	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	24571	CLINDAMICINA 600 MG 4 ML SI IM IV AP	0.0000	13.0800	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	00172	SORO FISIOLOGICO 0,9% 500 ML SI IV BS	0.0000	9.4698	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	00172	SORO FISIOLOGICO 0,9% 500 ML SI IV BS	0.0000	9.4698	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	081fdadb830fb547e83c43fabdb88372	ELZA	12377335349	NULL	12377335349	09071	ACETILCISTEINA 600MG PO VO SA	0.0000	3.5000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	081fdadb830fb547e83c43fabdb88372	ELZA	12377335349	NULL	12377335349	09071	ACETILCISTEINA 600MG PO VO SA	0.0000	3.5000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	081fdadb830fb547e83c43fabdb88372	ELZA	12377335349	NULL	12377335349	09071	ACETILCISTEINA 600MG PO VO SA	0.0000	3.5000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	081fdadb830fb547e83c43fabdb88372	ELZA	12377335349	NULL	12377335349	09071	ACETILCISTEINA 600MG PO VO SA	0.0000	3.5000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	081fdadb830fb547e83c43fabdb88372	ELZA	12377335349	NULL	12377335349	51240	FITA ADVANTAGE P/ GLICOSE UN	0.0000	5.1800	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1771	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1771	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1771	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1771	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.0000	0.4000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	26981	SORO FISIOLOGICO 0,9% 10 ML SI IV AP	0.0000	0.4800	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	26981	SORO FISIOLOGICO 0,9% 10 ML SI IV AP	0.0000	0.4800	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	02246	HIDROCORTISONA 100 MG PO IM IV FA	0.0000	2.8300	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	02246	HIDROCORTISONA 100 MG PO IM IV FA	0.0000	2.8300	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	02246	HIDROCORTISONA 100 MG PO IM IV FA	0.0000	2.8300	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	02246	HIDROCORTISONA 100 MG PO IM IV FA	0.0000	2.8300	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	02246	HIDROCORTISONA 100 MG PO IM IV FA	0.0000	2.8300	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	01611	CLORETO DE POTASSIO 600 MG CA VO UN	0.0000	0.4867	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	01611	CLORETO DE POTASSIO 600 MG CA VO UN	0.0000	0.4864	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1965b0cdebe9017c3397c8641147759	JOSE	12705413746	NULL	12705413746	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4074	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1965b0cdebe9017c3397c8641147759	JOSE	12705413746	NULL	12705413746	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4074	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1965b0cdebe9017c3397c8641147759	JOSE	12705413746	NULL	12705413746	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4074	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1965b0cdebe9017c3397c8641147759	JOSE	12705413746	NULL	12705413746	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4074	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1965b0cdebe9017c3397c8641147759	JOSE	12705413746	NULL	12705413746	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4074	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1965b0cdebe9017c3397c8641147759	JOSE	12705413746	NULL	12705413746	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4074	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1965b0cdebe9017c3397c8641147759	JOSE	12705413746	NULL	12705413746	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4074	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	d17b3c5ae418d82694895a326dee545a	ODILIA	12670516743	NULL	12670516743	51219	ALENIA	0.0000	1.1700	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	d17b3c5ae418d82694895a326dee545a	ODILIA	12670516743	NULL	12670516743	51208	SORO RINGER SIMPLES 500 ML SI IV BS	0.0000	5.9400	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	d17b3c5ae418d82694895a326dee545a	ODILIA	12670516743	NULL	12670516743	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	d17b3c5ae418d82694895a326dee545a	ODILIA	12670516743	NULL	12670516743	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	d17b3c5ae418d82694895a326dee545a	ODILIA	12670516743	NULL	12670516743	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	d17b3c5ae418d82694895a326dee545a	ODILIA	12670516743	NULL	12670516743	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	d17b3c5ae418d82694895a326dee545a	ODILIA	12670516743	NULL	12670516743	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	d17b3c5ae418d82694895a326dee545a	ODILIA	12670516743	NULL	12670516743	02197	METAMUCIL (PLANTAGO OVATA) 3,4 G PO VO EV	0.0000	2.4600	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	d17b3c5ae418d82694895a326dee545a	ODILIA	12670516743	NULL	12670516743	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	d17b3c5ae418d82694895a326dee545a	ODILIA	12670516743	NULL	12670516743	00128	LUVA DE PROCEDIMENTO UNIDADE UN	0.0000	1.0000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	d17b3c5ae418d82694895a326dee545a	ODILIA	12670516743	NULL	12670516743	00128	LUVA DE PROCEDIMENTO UNIDADE UN	0.0000	1.0000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	d17b3c5ae418d82694895a326dee545a	ODILIA	12670516743	NULL	12670516743	51230	AGULHA DESC 30 X 7 - 40X12 UN	NULL	0.0000	NULL	OPME INVALIDO	2201
Glosa Min	2018-10-03 00:00:00.000000	1084117	ea4ad2636c25d8e3dbb569ae62db71e7	IONE	12489788840	NULL	12489788840	00737	CEFTRIAXONA IV 1G + DIL. 10 ML PO IV FA	0.0000	27.0600	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	ea4ad2636c25d8e3dbb569ae62db71e7	IONE	12489788840	NULL	12489788840	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1800	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	ea4ad2636c25d8e3dbb569ae62db71e7	IONE	12489788840	NULL	12489788840	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1800	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	ea4ad2636c25d8e3dbb569ae62db71e7	IONE	12489788840	NULL	12489788840	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1800	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	ea4ad2636c25d8e3dbb569ae62db71e7	IONE	12489788840	NULL	12489788840	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.0000	0.4000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	26981	SORO FISIOLOGICO 0,9% 10 ML SI IV AP	0.0000	0.9600	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	24082	BROMOPRIDA 5 MG/ML 2 ML SI IM IV AP	0.0000	2.7300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	24082	BROMOPRIDA 5 MG/ML 2 ML SI IM IV AP	0.0000	2.7300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	24082	BROMOPRIDA 5 MG/ML 2 ML SI IM IV AP	0.0000	2.7300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00189	GLICONATO DE CALCIO 100 MG/ML10ML SI IV AP	0.0000	1.4500	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00171	SORO FISIOLOGICO 0,9% 250 ML SI IV BS	0.0000	3.9400	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00169	SORO GLICOSADO 5% 500 ML SI IV BS	0.0000	3.6715	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	01584	NEOSTIGMINA 0,5 MG/ML 1 ML SI IM IV SC AP	0.0000	2.3000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	01584	NEOSTIGMINA 0,5 MG/ML 1 ML SI IM IV SC AP	0.0000	0.7662	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	01584	NEOSTIGMINA 0,5 MG/ML 1 ML SI IM IV SC AP	0.0000	0.7656	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	01496	FENITOINA 50 MG/ML 5 ML SI IM IV AP	0.0000	2.3400	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	01496	FENITOINA 50 MG/ML 5 ML SI IM IV AP	0.0000	2.3400	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	01496	FENITOINA 50 MG/ML 5 ML SI IM IV AP	0.0000	2.3400	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	01496	FENITOINA 50 MG/ML 5 ML SI IM IV AP	0.0000	2.3400	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00128	LUVA DE PROCEDIMENTO UNIDADE UN	0.0000	1.6700	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00124	LUVA CIRURGICA UN	0.0000	1.4478	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00124	LUVA CIRURGICA UN	0.0000	1.4478	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	53945	ACIDO ASCORBICO 500 MG CP VO UN	0.0000	0.5900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	53945	ACIDO ASCORBICO 500 MG CP VO UN	0.0000	0.5900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.0000	0.6874	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.0000	0.6874	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	52392	SONDA DE ASPIRAÇAO TRAQUEAL C/ VALVULA UN	0.0000	0.9352	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	52392	SONDA DE ASPIRAÇAO TRAQUEAL C/ VALVULA UN	0.0000	0.9352	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	52392	SONDA DE ASPIRAÇAO TRAQUEAL C/ VALVULA UN	0.0000	0.9352	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	52392	SONDA DE ASPIRAÇAO TRAQUEAL C/ VALVULA UN	0.0000	0.9352	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	51649	ALCOOL ETILICO 70 % ST TP ML	0.0000	0.0300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	51649	ALCOOL ETILICO 70 % ST TP ML	0.0000	0.0300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	51241	AGULHA 123X45	0.0000	0.1900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	51241	AGULHA 123X45	0.0000	0.1900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1752	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1752	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1752	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.0000	0.4000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	35382	COMPRESSAS DE GASES 7.5 X7,5 (11 FIOS ESTERIL) UN	0.0000	0.0600	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	00128	LUVA DE PROCEDIMENTO UNIDADE UN	0.0000	1.6700	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	00124	LUVA CIRURGICA UN	0.0000	1.4500	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	00124	LUVA CIRURGICA UN	0.0000	1.4482	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	00124	LUVA CIRURGICA UN	0.0000	1.4482	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	00124	LUVA CIRURGICA UN	0.0000	1.4482	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	00124	LUVA CIRURGICA UN	0.0000	1.4482	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	00124	LUVA CIRURGICA UN	0.0000	1.4500	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	00124	LUVA CIRURGICA UN	0.0000	1.4500	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12579183644	NULL	12579183644	00091	SERINGA DESC 01 ML (INSULINA) UN	0.0000	0.3050	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12579183644	NULL	12579183644	00090	SERINGA DESC 20 ML UN	0.0000	0.5367	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12579183644	NULL	12579183644	51584	ESPARADRAPO MICROPORE	0.0000	0.2600	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12579183644	NULL	12579183644	51584	ESPARADRAPO MICROPORE	0.0000	0.2600	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12579183644	NULL	12579183644	51584	ESPARADRAPO MICROPORE	0.0000	0.2600	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12579183644	NULL	12579183644	51584	ESPARADRAPO MICROPORE	0.0000	0.2600	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12579183644	NULL	12579183644	35382	COMPRESSAS DE GASES 7.5 X7,5 (11 FIOS ESTERIL) UN	0.0000	0.3000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12579183644	NULL	12579183644	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12579183644	NULL	12579183644	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12579183644	NULL	12579183644	25040014	Fisioterapia Respiratória - em Doente Clínico Internado	0.0000	10.0600	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12579183644	NULL	12579183644	00124	LUVA CIRURGICA UN	0.0000	1.4476	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12579183644	NULL	12579183644	00124	LUVA CIRURGICA UN	0.0000	1.4476	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12579183644	NULL	12579183644	00124	LUVA CIRURGICA UN	0.0000	1.4476	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	9ffbbf7340bbd65e9e3baa9406d027f3	MARCO	12261811645	NULL	12261811645	00090	SERINGA DESC 20 ML UN	0.0000	0.5376	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	9ffbbf7340bbd65e9e3baa9406d027f3	MARCO	12261811645	NULL	12261811645	00090	SERINGA DESC 20 ML UN	0.0000	0.5376	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	9ffbbf7340bbd65e9e3baa9406d027f3	MARCO	12261811645	NULL	12261811645	00090	SERINGA DESC 20 ML UN	0.0000	0.5376	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12550571048	NULL	12550571048	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1775	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12550571048	NULL	12550571048	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1775	NULL	VALOR APRESENTADO A MAIOR	1705
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12550571048	NULL	12550571048	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1775	NULL	VALOR APRESENTADO A MAIOR	1705
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12550571048	NULL	12550571048	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1775	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12550571048	NULL	12550571048	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1775	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12550571048	NULL	12550571048	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1775	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12550571048	NULL	12550571048	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1775	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12550571048	NULL	12550571048	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1775	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12550571048	NULL	12550571048	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1775	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12550571048	NULL	12550571048	51219	ALENIA	0.0000	1.1700	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12550571048	NULL	12550571048	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.0000	0.8089	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12550571048	NULL	12550571048	000501	OXIGENIO	0.0000	948.0711	NULL	COBRANCA DE GASES INCOMPATIVEL COM O UTILIZADO/ PRESCRITO	2310
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12550571048	NULL	12550571048	29020166	Nebulização Simples com Broncodilatador	0.0000	7.0200	NULL	EXAME NAO AUTORIZADO	2707
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12550571048	NULL	12550571048	25040014	Fisioterapia Respiratória - em Doente Clínico Internado	0.0000	5.0300	NULL	EXAME NAO AUTORIZADO	2707
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12550571048	NULL	12550571048	02246	HIDROCORTISONA 100 MG PO IM IV FA	0.0000	5.6697	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12550571048	NULL	12550571048	02246	HIDROCORTISONA 100 MG PO IM IV FA	0.0000	5.6697	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12550571048	NULL	12550571048	02246	HIDROCORTISONA 100 MG PO IM IV FA	0.0000	5.6697	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12550571048	NULL	12550571048	00182	SULFATO DE MAGNESIO 500 MG/ML 10 ML SI IM IV AP	0.0000	1.3600	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12550571048	NULL	12550571048	01611	CLORETO DE POTASSIO 600 MG CA VO UN	0.0000	0.4867	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12550571048	NULL	12550571048	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4074	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12550571048	NULL	12550571048	00124	LUVA CIRURGICA UN	0.0000	1.4473	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12550571048	NULL	12550571048	00124	LUVA CIRURGICA UN	0.0000	1.4473	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12550571048	NULL	12550571048	00124	LUVA CIRURGICA UN	0.0000	1.4500	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00090	SERINGA DESC 20 ML UN	0.0000	0.5387	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00090	SERINGA DESC 20 ML UN	0.0000	0.5387	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00090	SERINGA DESC 20 ML UN	0.0000	0.5387	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00090	SERINGA DESC 20 ML UN	0.0000	0.5387	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00090	SERINGA DESC 20 ML UN	0.0000	0.5387	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00090	SERINGA DESC 20 ML UN	0.0000	0.5387	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00090	SERINGA DESC 20 ML UN	0.0000	0.5387	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00090	SERINGA DESC 20 ML UN	0.0000	0.5387	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00090	SERINGA DESC 20 ML UN	0.0000	0.5387	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00090	SERINGA DESC 20 ML UN	0.0000	0.5387	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00090	SERINGA DESC 20 ML UN	0.0000	0.5387	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00090	SERINGA DESC 20 ML UN	0.0000	0.5387	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00090	SERINGA DESC 20 ML UN	0.0000	0.5387	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00090	SERINGA DESC 20 ML UN	0.0000	0.5387	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1766	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1766	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1766	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1766	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1766	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4088	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4088	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4088	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4088	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4088	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4088	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00943	EQUIPO POLIFIX 2 VIAS UN	0.0000	2.5500	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00090	SERINGA DESC 20 ML UN	0.0000	0.5371	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00090	SERINGA DESC 20 ML UN	0.0000	0.5371	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00090	SERINGA DESC 20 ML UN	0.0000	0.5371	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00090	SERINGA DESC 20 ML UN	0.0000	0.5371	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00090	SERINGA DESC 20 ML UN	0.0000	0.5371	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00090	SERINGA DESC 20 ML UN	0.0000	0.5371	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00090	SERINGA DESC 20 ML UN	0.0000	0.5371	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00090	SERINGA DESC 20 ML UN	0.0000	0.5371	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00090	SERINGA DESC 20 ML UN	0.0000	0.5400	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00090	SERINGA DESC 20 ML UN	0.0000	0.5371	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00090	SERINGA DESC 20 ML UN	0.0000	0.5371	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00090	SERINGA DESC 20 ML UN	0.0000	0.5371	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00090	SERINGA DESC 20 ML UN	0.0000	0.5371	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00090	SERINGA DESC 20 ML UN	0.0000	0.5371	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	24082	BROMOPRIDA 5 MG/ML 2 ML SI IM IV AP	0.0000	2.7300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	24082	BROMOPRIDA 5 MG/ML 2 ML SI IM IV AP	0.0000	2.7300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	24082	BROMOPRIDA 5 MG/ML 2 ML SI IM IV AP	0.0000	2.7300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	24082	BROMOPRIDA 5 MG/ML 2 ML SI IM IV AP	0.0000	2.7300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	24082	BROMOPRIDA 5 MG/ML 2 ML SI IM IV AP	0.0000	2.7300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	24082	BROMOPRIDA 5 MG/ML 2 ML SI IM IV AP	0.0000	2.7300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00170	SORO GLICOSADO 5% 250 ML SI IV BS	0.0000	3.4000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	01584	NEOSTIGMINA 0,5 MG/ML 1 ML SI IM IV SC AP	0.0000	0.7667	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	01584	NEOSTIGMINA 0,5 MG/ML 1 ML SI IM IV SC AP	0.0000	0.7667	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	01584	NEOSTIGMINA 0,5 MG/ML 1 ML SI IM IV SC AP	0.0000	0.7667	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	01584	NEOSTIGMINA 0,5 MG/ML 1 ML SI IM IV SC AP	0.0000	0.7667	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	01584	NEOSTIGMINA 0,5 MG/ML 1 ML SI IM IV SC AP	0.0000	0.7667	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4062	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4062	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4062	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4062	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4062	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4062	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4062	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4062	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4062	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4062	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00124	LUVA CIRURGICA UN	0.0000	1.4475	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00124	LUVA CIRURGICA UN	0.0000	1.4475	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00124	LUVA CIRURGICA UN	0.0000	1.4475	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00091	SERINGA DESC 01 ML (INSULINA) UN	0.0000	0.3057	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	09071	ACETILCISTEINA 600MG PO VO SA	0.0000	3.4950	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	09071	ACETILCISTEINA 600MG PO VO SA	0.0000	3.4950	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	07802	PIPERACILINA 4 G + TAZOBACTAM 500 MG PO IV FA	0.0000	0.0000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	07802	PIPERACILINA 4 G + TAZOBACTAM 500 MG PO IV FA	0.0000	0.0000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	07802	PIPERACILINA 4 G + TAZOBACTAM 500 MG PO IV FA	0.0000	83.4500	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00613	CLINDAMICINA 600 MG 4 ML SI IM IV AP	0.0000	13.0800	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00613	CLINDAMICINA 600 MG 4 ML SI IM IV AP	0.0000	13.0800	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.0000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	26981	SORO FISIOLOGICO 0,9% 10 ML SI IV AP	0.0000	0.0000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	02358	CLORETO DE SODIO 17,55% 10 ML SI IV AP	0.0000	1.1200	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	02246	HIDROCORTISONA 100 MG PO IM IV FA	0.0000	2.8300	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00171	SORO FISIOLOGICO 0,9% 250 ML SI IV BS	0.0000	3.9400	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00171	SORO FISIOLOGICO 0,9% 250 ML SI IV BS	0.0000	3.9400	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	01611	CLORETO DE POTASSIO 600 MG CA VO UN	0.0000	0.0000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	0.0000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	05975	COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER	0.7739	0.8059	-0.7759	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	11193	CLOREXIDINA 2 % ST TP ML	0.5300	0.5320	-0.0020	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	11193	CLOREXIDINA 2 % ST TP ML	0.5300	0.5320	-0.0020	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	11193	CLOREXIDINA 2 % ST TP ML	0.5300	0.5320	-0.0020	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00817	ALGODAO HIDROFILO BOLINHA UN	0.2600	0.2860	-0.0260	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	07269	DIPIRONA 500 MG/ML 2 ML SI IV IM AP	0.6900	0.6860	0.0040	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	07269	DIPIRONA 500 MG/ML 2 ML SI IV IM AP	0.6900	0.6860	0.0040	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	19151	SERINGA DESC 10 ML UN	0.3300	0.6669	-0.3369	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	19151	SERINGA DESC 10 ML UN	0.3300	0.6669	-0.3369	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	31585	RANITIDINA 25 MG/ML 2 ML SI IV IM AP	0.9300	0.9334	-0.0034	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	31585	RANITIDINA 25 MG/ML 2 ML SI IV IM AP	0.9300	0.9334	-0.0034	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	31585	RANITIDINA 25 MG/ML 2 ML SI IV IM AP	0.9300	0.9334	-0.0034	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	31585	RANITIDINA 25 MG/ML 2 ML SI IV IM AP	0.9300	1.8668	-0.9368	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	19445	CLORETO DE POTASSIO 600 MG CA VO UN	0.9768	1.4605	-0.9705	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	19445	CLORETO DE POTASSIO 600 MG CA VO UN	0.9768	1.4605	-0.9705	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	19445	CLORETO DE POTASSIO 600 MG CA VO UN	1.4637	1.9474	-1.4574	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	19160	SERINGA DESC 20 ML UN	0.5400	0.5374	0.0026	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	27596	TIRA TESTE PARA GLICOSE UN	1.0400	1.0400	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	27596	TIRA TESTE PARA GLICOSE UN	1.0400	2.0800	-1.0400	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	34827	TIORFAN (RACECADOTRILA) 100 MG CA VO UN	3.2000	3.2000	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	34827	TIORFAN (RACECADOTRILA) 100 MG CA VO UN	3.2000	6.4000	-3.2000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.1060	-0.0060	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.1060	-0.0060	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.1060	-0.0060	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.1060	-0.0060	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.2120	-0.1120	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.2120	-0.1120	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	19151	SERINGA DESC 10 ML UN	0.3300	0.0000	0.3300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	34789	SONDA ASPIRAÇAO C/ VALVULA - TODAS - UTI UN	0.9400	0.9367	0.0033	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	NULL	0.0000	NULL	OPME INVALIDO	2201
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	NULL	0.0000	NULL	OPME INVALIDO	2201
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	000501	OXIGENIO	NULL	0.0000	NULL	OPME INVALIDO	2201
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	27060039	Unidade de Plasma	NULL	0.0000	NULL	OPME INVALIDO	2201
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1770	0.0030	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1770	0.0030	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1770	0.0030	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1770	0.0030	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1770	0.0030	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1770	0.0030	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1770	0.0030	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1770	0.0030	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1770	0.0030	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1760	0.0040	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12579183644	NULL	12579183644	33227	LUVA CIRURGICA PAR UN	1.4500	1.4476	0.0024	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12579183644	NULL	12579183644	33227	LUVA CIRURGICA PAR UN	1.4500	1.4476	0.0024	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12579183644	NULL	12579183644	33227	LUVA CIRURGICA PAR UN	1.4500	1.4476	0.0024	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12579183644	NULL	12579183644	33227	LUVA CIRURGICA PAR UN	1.4500	1.4476	0.0024	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12579183644	NULL	12579183644	05975	COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER	0.3000	0.0000	0.3000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12662414945	NULL	12662414945	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4071	0.0029	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12662414945	NULL	12662414945	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4071	0.0029	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12662414945	NULL	12662414945	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4071	0.0029	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12662414945	NULL	12662414945	42358	FUROSEMIDA 10 MG/ML 2 ML SI IM IV AP	1.2000	1.1967	0.0033	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12662414945	NULL	12662414945	13404	OMEPRAZOL 40 MG + DIL. 10 ML PO IV FA	19.5800	19.5750	0.0050	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12662414945	NULL	12662414945	19160	SERINGA DESC 20 ML UN	0.5400	0.5367	0.0033	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12662414945	NULL	12662414945	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1750	0.0050	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12647284040	NULL	12647284040	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4086	0.0014	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	05975	COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER	0.3000	0.0000	0.3000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	27596	TIRA TESTE PARA GLICOSE UN	1.0400	1.0400	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	27596	TIRA TESTE PARA GLICOSE UN	1.0400	1.0400	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	27596	TIRA TESTE PARA GLICOSE UN	1.0400	1.0400	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	37761	ALCOOL ETILICO 70 % ST TP ML	0.0600	0.0000	0.0600	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	52353	ABAIXADOR DE LINGUA UN	0.0500	0.0267	0.0233	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	37761	ALCOOL ETILICO 70 % ST TP ML	0.0300	0.0000	0.0300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	00817	ALGODAO HIDROFILO BOLINHA UN	0.5100	0.0000	0.5100	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	37761	ALCOOL ETILICO 70 % ST TP ML	0.0600	0.0000	0.0600	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	0111beed375944f60c7ad4a7fd4874f8	WALDIR	12746025744	NULL	12746025744	19160	SERINGA DESC 20 ML UN	0.5400	0.5379	0.0021	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	0111beed375944f60c7ad4a7fd4874f8	WALDIR	12746025744	NULL	12746025744	19160	SERINGA DESC 20 ML UN	0.5400	0.5379	0.0021	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	0111beed375944f60c7ad4a7fd4874f8	WALDIR	12746025744	NULL	12746025744	19160	SERINGA DESC 20 ML UN	0.5400	0.5383	0.0017	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	0111beed375944f60c7ad4a7fd4874f8	WALDIR	12746025744	NULL	12746025744	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4076	0.0024	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	0111beed375944f60c7ad4a7fd4874f8	WALDIR	12746025744	NULL	12746025744	00426	AGUA BIDESTILADA 10 ML SI IV IM AP	1.6200	1.6147	0.0053	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	0111beed375944f60c7ad4a7fd4874f8	WALDIR	12746025744	NULL	12746025744	00426	AGUA BIDESTILADA 10 ML SI IV IM AP	0.8100	0.8074	0.0026	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4070	0.0030	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	05975	COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER	0.0600	0.0000	0.0600	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	05975	COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER	0.0300	0.0001	0.0299	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	32204	CLORETO DE SODIO 0,9% 10 ML SI IV AP	0.9600	0.9600	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	32204	CLORETO DE SODIO 0,9% 10 ML SI IV AP	0.4800	0.0000	0.4800	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	8a5ecfde671848d05ac757e0112e689c	TEREZINHA	12700337042	NULL	12700337042	19160	SERINGA DESC 20 ML UN	0.5400	0.5376	0.0024	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	8a5ecfde671848d05ac757e0112e689c	TEREZINHA	12700337042	NULL	12700337042	19160	SERINGA DESC 20 ML UN	0.5400	0.5376	0.0024	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	8a5ecfde671848d05ac757e0112e689c	TEREZINHA	12700337042	NULL	12700337042	19160	SERINGA DESC 20 ML UN	0.5400	0.5376	0.0024	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	8a5ecfde671848d05ac757e0112e689c	TEREZINHA	12700337042	NULL	12700337042	19160	SERINGA DESC 20 ML UN	0.5400	0.5376	0.0024	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	8a5ecfde671848d05ac757e0112e689c	TEREZINHA	12700337042	NULL	12700337042	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4071	0.0029	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	8a5ecfde671848d05ac757e0112e689c	TEREZINHA	12700337042	NULL	12700337042	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4071	0.0029	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	8a5ecfde671848d05ac757e0112e689c	TEREZINHA	12700337042	NULL	12700337042	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4071	0.0029	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	8a5ecfde671848d05ac757e0112e689c	TEREZINHA	12700337042	NULL	12700337042	57258	FUMARATO DE QUETIAPINA 25 MG CA VO UN	1.2500	1.2450	0.0050	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	8a5ecfde671848d05ac757e0112e689c	TEREZINHA	12700337042	NULL	12700337042	57258	FUMARATO DE QUETIAPINA 25 MG CA VO UN	1.2500	1.2450	0.0050	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	8a5ecfde671848d05ac757e0112e689c	TEREZINHA	12700337042	NULL	12700337042	09733	ACETILCISTEINA 600MG PO VO SA	3.5000	3.4967	0.0033	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	8a5ecfde671848d05ac757e0112e689c	TEREZINHA	12700337042	NULL	12700337042	09733	ACETILCISTEINA 600MG PO VO SA	3.5000	3.4967	0.0033	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	8a5ecfde671848d05ac757e0112e689c	TEREZINHA	12700337042	NULL	12700337042	10626	GLICOSE 50% 10 ML SI IV AP	2.7400	2.7350	0.0050	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00426	AGUA BIDESTILADA 10 ML SI IV IM AP	1.6200	1.6154	0.0046	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1766	0.0034	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1766	0.0034	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1766	0.0034	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1766	0.0034	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	d17b3c5ae418d82694895a326dee545a	ODILIA	12670516743	NULL	12670516743	00817	ALGODAO HIDROFILO BOLINHA UN	0.1300	0.1300	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	d17b3c5ae418d82694895a326dee545a	ODILIA	12670516743	NULL	12670516743	30376	BROMETO DE IPRATROPIO 0,25MG/ML SL IN GT	0.4000	0.0000	0.4000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	cd2840524be5a3f1d0939f241e24f32b	MARIA	12705908340	NULL	12705908340	02461	FENOTEROL 2 MG/ML 10 ML AE IN DS	0.4300	0.0000	0.4300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	cd2840524be5a3f1d0939f241e24f32b	MARIA	12705908340	NULL	12705908340	30376	BROMETO DE IPRATROPIO 0,25MG/ML SL IN GT	0.4000	0.0000	0.4000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	cd2840524be5a3f1d0939f241e24f32b	MARIA	12705908340	NULL	12705908340	30376	BROMETO DE IPRATROPIO 0,25MG/ML SL IN GT	0.4000	0.0000	0.4000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	cd2840524be5a3f1d0939f241e24f32b	MARIA	12705908340	NULL	12705908340	32204	CLORETO DE SODIO 0,9% 10 ML SI IV AP	0.4800	0.4800	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	08664	ESPARADRAPO MICROPORE 50 X 10 CM CM	0.7700	0.7670	0.0030	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	08664	ESPARADRAPO MICROPORE 50 X 10 CM CM	0.7700	0.7670	0.0030	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1772	0.0028	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1772	0.0028	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1772	0.0028	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1772	0.0028	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.2100	0.2057	0.0043	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	19151	SERINGA DESC 10 ML UN	0.6700	0.6657	0.0043	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	19151	SERINGA DESC 10 ML UN	0.6700	0.6657	0.0043	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00817	ALGODAO HIDROFILO BOLINHA UN	0.1000	0.0000	0.1000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	08664	ESPARADRAPO MICROPORE 50 X 10 CM CM	0.7700	0.2550	0.5150	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	53660	EQUIPO MACRO-GOTAS FLEXIVEL C/ INJETOR LATE	1.5900	0.0000	1.5900	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4061	0.0039	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4061	0.0039	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4061	0.0039	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4061	0.0039	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4061	0.0039	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4061	0.0039	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4061	0.0039	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4061	0.0039	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4061	0.0039	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4061	0.0039	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	42358	FUROSEMIDA 10 MG/ML 2 ML SI IM IV AP	1.2000	1.1964	0.0036	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	42358	FUROSEMIDA 10 MG/ML 2 ML SI IM IV AP	1.2000	1.1960	0.0040	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	33537	PIPERACILINA 2 G + TAZOBACTAM 250 MG 30 ML	55.3400	55.3375	0.0025	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	33537	PIPERACILINA 2 G + TAZOBACTAM 250 MG 30 ML	55.3400	55.3375	0.0025	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	33537	PIPERACILINA 2 G + TAZOBACTAM 250 MG 30 ML	55.3400	55.3375	0.0025	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	11193	CLOREXIDINA 2 % ST TP ML	0.5300	0.5300	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	05975	COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER	0.3000	0.0000	0.3000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	05975	COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER	0.3000	0.0000	0.3000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	11193	CLOREXIDINA 2 % ST TP ML	0.2700	0.0000	0.2700	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	e715e2ae28a6229c8609756d3298bf52	MARIA	12734221144	NULL	12734221144	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1750	0.0050	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	33219	LUVA DE PROCEDIMENTO UNIDADE UN	1.0000	0.6700	0.3300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	32204	CLORETO DE SODIO 0,9% 10 ML SI IV AP	0.9600	0.0000	0.9600	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	32204	CLORETO DE SODIO 0,9% 10 ML SI IV AP	0.4800	0.0000	0.4800	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	32204	CLORETO DE SODIO 0,9% 10 ML SI IV AP	0.4800	0.0000	0.4800	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	32204	CLORETO DE SODIO 0,9% 10 ML SI IV AP	0.4800	0.0000	0.4800	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4088	0.0012	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	00426	AGUA BIDESTILADA 10 ML SI IV IM AP	0.8100	0.8067	0.0033	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	00426	AGUA BIDESTILADA 10 ML SI IV IM AP	0.8100	0.8067	0.0033	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	30376	BROMETO DE IPRATROPIO 0,25MG/ML SL IN GT	0.6000	0.0000	0.6000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	30376	BROMETO DE IPRATROPIO 0,25MG/ML SL IN GT	0.6000	0.0000	0.6000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	32204	CLORETO DE SODIO 0,9% 10 ML SI IV AP	0.4800	0.0000	0.4800	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	32204	CLORETO DE SODIO 0,9% 10 ML SI IV AP	0.4800	0.4800	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	32204	CLORETO DE SODIO 0,9% 10 ML SI IV AP	0.4800	0.0000	0.4800	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	02461	FENOTEROL 2 MG/ML 10 ML AE IN DS	0.3400	0.0000	0.3400	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	32204	CLORETO DE SODIO 0,9% 10 ML SI IV AP	0.4800	0.0000	0.4800	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1965b0cdebe9017c3397c8641147759	JOSE	12705413746	NULL	12705413746	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4074	0.0026	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.1036	-0.0036	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4084	0.0016	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4084	0.0016	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4084	0.0016	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4084	0.0016	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4084	0.0016	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	05975	COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER	0.6000	0.3833	0.2167	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	05975	COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER	0.3000	0.0000	0.3000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	53660	EQUIPO MACRO-GOTAS FLEXIVEL C/ INJETOR LATE	1.5900	0.0000	1.5900	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1900	0.1900	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1900	0.1900	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	b288bbcfb9aecab51bcb0dba62ca0059	IVONETE	12743730847	NULL	12743730847	19160	SERINGA DESC 20 ML UN	0.5400	0.5367	0.0033	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	b288bbcfb9aecab51bcb0dba62ca0059	IVONETE	12743730847	NULL	12743730847	19160	SERINGA DESC 20 ML UN	0.5400	0.5367	0.0033	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	b288bbcfb9aecab51bcb0dba62ca0059	IVONETE	12743730847	NULL	12743730847	19160	SERINGA DESC 20 ML UN	0.5400	0.5367	0.0033	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	b288bbcfb9aecab51bcb0dba62ca0059	IVONETE	12743730847	NULL	12743730847	19160	SERINGA DESC 20 ML UN	0.5400	0.5367	0.0033	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	b288bbcfb9aecab51bcb0dba62ca0059	IVONETE	12743730847	NULL	12743730847	19160	SERINGA DESC 20 ML UN	0.5400	0.5367	0.0033	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	b288bbcfb9aecab51bcb0dba62ca0059	IVONETE	12743730847	NULL	12743730847	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4067	0.0033	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.1038	-0.0038	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.1038	-0.0038	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	33227	LUVA CIRURGICA PAR UN	1.4500	1.4476	0.0024	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	33227	LUVA CIRURGICA PAR UN	1.4500	1.4476	0.0024	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	33227	LUVA CIRURGICA PAR UN	1.4500	1.4476	0.0024	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	33227	LUVA CIRURGICA PAR UN	1.4500	1.4476	0.0024	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	33227	LUVA CIRURGICA PAR UN	1.4500	1.4476	0.0024	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	33227	LUVA CIRURGICA PAR UN	1.4500	1.4476	0.0024	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4078	0.0022	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4078	0.0022	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4078	0.0022	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4078	0.0022	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	42358	FUROSEMIDA 10 MG/ML 2 ML SI IM IV AP	0.6000	0.5986	0.0014	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	58661	ENCRISE (ARGIPRESSINA) 20 U/ML 1 ML SI SC	40.2400	40.2343	0.0057	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	37761	ALCOOL ETILICO 70 % ST TP ML	0.0200	0.0150	0.0050	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	08664	ESPARADRAPO MICROPORE 50 X 10 CM CM	0.7700	0.7682	0.0018	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	08664	ESPARADRAPO MICROPORE 50 X 10 CM CM	0.2600	0.2561	0.0039	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	eecb3d883747b059c3fe231c34567476	AFFRIDES	12693180144	NULL	12693180144	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4074	0.0026	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	eecb3d883747b059c3fe231c34567476	AFFRIDES	12693180144	NULL	12693180144	09733	ACETILCISTEINA 600MG PO VO SA	3.5000	3.4955	0.0045	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	eecb3d883747b059c3fe231c34567476	AFFRIDES	12693180144	NULL	12693180144	09733	ACETILCISTEINA 600MG PO VO SA	3.5000	3.4955	0.0045	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	eecb3d883747b059c3fe231c34567476	AFFRIDES	12693180144	NULL	12693180144	09733	ACETILCISTEINA 600MG PO VO SA	3.5000	3.4955	0.0045	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	eecb3d883747b059c3fe231c34567476	AFFRIDES	12693180144	NULL	12693180144	09733	ACETILCISTEINA 600MG PO VO SA	3.5000	3.4955	0.0045	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	eecb3d883747b059c3fe231c34567476	AFFRIDES	12693180144	NULL	12693180144	09733	ACETILCISTEINA 600MG PO VO SA	3.5000	3.4955	0.0045	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	eecb3d883747b059c3fe231c34567476	AFFRIDES	12693180144	NULL	12693180144	09733	ACETILCISTEINA 600MG PO VO SA	3.5000	3.4955	0.0045	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	eecb3d883747b059c3fe231c34567476	AFFRIDES	12693180144	NULL	12693180144	00426	AGUA BIDESTILADA 10 ML SI IV IM AP	0.8100	0.8072	0.0028	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	eecb3d883747b059c3fe231c34567476	AFFRIDES	12693180144	NULL	12693180144	00426	AGUA BIDESTILADA 10 ML SI IV IM AP	0.8100	0.8072	0.0028	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	eecb3d883747b059c3fe231c34567476	AFFRIDES	12693180144	NULL	12693180144	00426	AGUA BIDESTILADA 10 ML SI IV IM AP	0.8100	0.8072	0.0028	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	eecb3d883747b059c3fe231c34567476	AFFRIDES	12693180144	NULL	12693180144	00426	AGUA BIDESTILADA 10 ML SI IV IM AP	0.8100	0.8072	0.0028	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	eecb3d883747b059c3fe231c34567476	AFFRIDES	12693180144	NULL	12693180144	00426	AGUA BIDESTILADA 10 ML SI IV IM AP	0.8100	0.8072	0.0028	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	eecb3d883747b059c3fe231c34567476	AFFRIDES	12693180144	NULL	12693180144	00426	AGUA BIDESTILADA 10 ML SI IV IM AP	0.8100	0.8072	0.0028	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	eecb3d883747b059c3fe231c34567476	AFFRIDES	12693180144	NULL	12693180144	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1770	0.0030	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	eecb3d883747b059c3fe231c34567476	AFFRIDES	12693180144	NULL	12693180144	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1770	0.0030	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	eecb3d883747b059c3fe231c34567476	AFFRIDES	12693180144	NULL	12693180144	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1770	0.0030	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	eecb3d883747b059c3fe231c34567476	AFFRIDES	12693180144	NULL	12693180144	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1770	0.0030	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	eecb3d883747b059c3fe231c34567476	AFFRIDES	12693180144	NULL	12693180144	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1770	0.0030	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	eecb3d883747b059c3fe231c34567476	AFFRIDES	12693180144	NULL	12693180144	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1770	0.0030	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	eecb3d883747b059c3fe231c34567476	AFFRIDES	12693180144	NULL	12693180144	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1770	0.0030	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	eecb3d883747b059c3fe231c34567476	AFFRIDES	12693180144	NULL	12693180144	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1770	0.0030	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	de1a8276d878171456d7fc8f6dcd2457	ABEL	12764206443	NULL	12764206443	07269	DIPIRONA 500 MG/ML 2 ML SI IV IM AP	0.6900	0.6867	0.0033	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	01081197	077051bf3e8309e603928bbc982a522c	KARLA	12660344627	NULL	12660344627	20010010	ECG - ELETROCARDIOGRAMA	0.0000	11.5710	NULL	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	ea6abb4182a48f0934f3e9eb5affa056	DILVA	12697455440	NULL	12697455440	29020166	NEBULIZACAO SIMPLES COM BRONCODILAT	0.0000	26.9300	NULL	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	01081195	a6786839bc6f6afb2125c1877c91c932	MARIA	12742490110	NULL	12742490110	00010014	CONSULTA EM CONSULTORIO MEDICO	0.0000	35.0000	NULL	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	32891	EQUIPO POLIFIX 2ş VIAS UN	7.6500	2.5500	5.1000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	4668d2494ed6c4b2d18be299efcb26a2	JOAO	12469689344	NULL	12469689344	05975	COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER	0.0300	0.0000	0.0300	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	cb57fc8e673b7c8bc339e1fe25d70cd5	HELIO	12661165148	NULL	12661165148	07269	DIPIRONA 500 MG/ML 2 ML SI IV IM AP	0.6900	0.6867	0.0033	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	cb57fc8e673b7c8bc339e1fe25d70cd5	HELIO	12661165148	NULL	12661165148	07269	DIPIRONA 500 MG/ML 2 ML SI IV IM AP	0.6900	0.6867	0.0033	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	39df67956a358bf1eab89803158d25dd	HELENA	12655863342	NULL	12655863342	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1750	0.0050	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	39df67956a358bf1eab89803158d25dd	HELENA	12655863342	NULL	12655863342	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1750	0.0050	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	39df67956a358bf1eab89803158d25dd	HELENA	12655863342	NULL	12655863342	27480	CLARITROMICINA 500 MG 30 ML PO IV FA	117.1100	117.1050	0.0050	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	39df67956a358bf1eab89803158d25dd	HELENA	12655863342	NULL	12655863342	00817	ALGODAO HIDROFILO BOLINHA UN	0.1300	0.1200	0.0000	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	edffb7fef608512400078fdf75991573	CARLA	12728631049	NULL	12728631049	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1760	0.0040	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	a050ed50115d2a6dd0b15b99b39063da	ARI	12676101147	NULL	12676101147	19160	SERINGA DESC 20 ML UN	0.5400	0.5367	0.0033	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	a050ed50115d2a6dd0b15b99b39063da	ARI	12676101147	NULL	12676101147	19160	SERINGA DESC 20 ML UN	0.5400	0.5364	0.0036	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	33219	LUVA DE PROCEDIMENTO UNIDADE UN	1.0000	0.6700	0.3300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	818a6f2e549cc6a60aa20f9d0595eec9	ANTONIO	12565134343	NULL	12565134343	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1767	0.0033	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	818a6f2e549cc6a60aa20f9d0595eec9	ANTONIO	12565134343	NULL	12565134343	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1767	0.0033	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	818a6f2e549cc6a60aa20f9d0595eec9	ANTONIO	12565134343	NULL	12565134343	19160	SERINGA DESC 20 ML UN	0.5400	0.5371	0.0029	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	818a6f2e549cc6a60aa20f9d0595eec9	ANTONIO	12565134343	NULL	12565134343	19160	SERINGA DESC 20 ML UN	0.5400	0.5371	0.0029	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	818a6f2e549cc6a60aa20f9d0595eec9	ANTONIO	12565134343	NULL	12565134343	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4000	0.0000	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	edffb7fef608512400078fdf75991573	CARLA	12728631049	NULL	12728631049	000435	TAXA DE RESPIRADOR A VOLUME (MAI)	0.0000	0.0000	NULL	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	19151	SERINGA DESC 10 ML UN	0.3300	0.0000	0.3300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.0000	0.1000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	08648	ESPARADRAPO 10 X 4.5 CM CM	0.4000	0.2000	0.2000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	02461	FENOTEROL 2 MG/ML 10 ML AE IN DS	2.5500	0.0000	2.5500	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	08648	ESPARADRAPO 10 X 4.5 CM CM	0.4000	0.2000	0.2000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12603877940	NULL	12603877940	37761	ALCOOL ETILICO 70 % ST TP ML	0.0300	0.0200	0.0100	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12603877940	NULL	12603877940	55018	ALGINATO DE CALCIO EM HIDROGEL GL TP GR	17.2500	13.8000	3.4500	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12603877940	NULL	12603877940	13757	IODOPOVIDONA SD TP ML	0.4000	0.0000	0.4000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12603877940	NULL	12603877940	00817	ALGODAO HIDROFILO BOLINHA UN	0.2600	0.1300	0.1300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12603877940	NULL	12603877940	06343	CLINDAMICINA 600 MG 4 ML SI IM IV AP	39.2400	0.0000	39.2400	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	cd2840524be5a3f1d0939f241e24f32b	MARIA	12705908340	NULL	12705908340	52582	CATETER OXIGENIO TIPO OCULOS UN	1.0000	0.0000	1.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	cd2840524be5a3f1d0939f241e24f32b	MARIA	12705908340	NULL	12705908340	00817	ALGODAO HIDROFILO BOLINHA UN	0.2600	0.1300	0.1300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	cd2840524be5a3f1d0939f241e24f32b	MARIA	12705908340	NULL	12705908340	37761	ALCOOL ETILICO 70 % ST TP ML	0.0300	0.0200	0.0100	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	cd2840524be5a3f1d0939f241e24f32b	MARIA	12705908340	NULL	12705908340	00817	ALGODAO HIDROFILO BOLINHA UN	0.2600	0.1300	0.1300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	cd2840524be5a3f1d0939f241e24f32b	MARIA	12705908340	NULL	12705908340	00817	ALGODAO HIDROFILO BOLINHA UN	0.2600	0.1300	0.1300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	cd2840524be5a3f1d0939f241e24f32b	MARIA	12705908340	NULL	12705908340	33219	LUVA DE PROCEDIMENTO UNIDADE UN	1.0000	0.6700	0.3300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	cd2840524be5a3f1d0939f241e24f32b	MARIA	12705908340	NULL	12705908340	00817	ALGODAO HIDROFILO BOLINHA UN	0.2600	0.1300	0.1300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	11134	HEPARINA 5000 UI/ML 5 ML SI IV SC ML	14.4000	2.8800	11.5200	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	14370	FIO MONONYLON 3-0 C/ AGULHA 2,4 3/8 163T E	13.3700	0.0000	13.3700	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	01724	ATADURA CREPOM 10 CM UN	0.7900	0.0000	0.7900	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.0000	0.1800	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	14664	NALOXONA 0,4 MG/ML 1 ML SI IM IV SC AP	7.4200	0.0000	7.4200	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	33219	LUVA DE PROCEDIMENTO UNIDADE UN	1.0000	0.6700	0.3300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	37761	ALCOOL ETILICO 70 % ST TP ML	0.0600	0.0300	0.0300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	37761	ALCOOL ETILICO 70 % ST TP ML	0.0600	0.0300	0.0300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	d4089ccef13567fd45b16fb0b60685fa	VERA	12656425943	NULL	12656425943	33219	LUVA DE PROCEDIMENTO UNIDADE UN	1.0000	0.0000	1.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	d4089ccef13567fd45b16fb0b60685fa	VERA	12656425943	NULL	12656425943	33219	LUVA DE PROCEDIMENTO UNIDADE UN	1.6700	0.6700	1.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	d4089ccef13567fd45b16fb0b60685fa	VERA	12656425943	NULL	12656425943	33219	LUVA DE PROCEDIMENTO UNIDADE UN	0.6700	0.0000	0.6700	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	5f044434edae42d3d17c4392018c7824	DINORA	12673932742	NULL	12673932742	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.0000	0.1000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	9ffbbf7340bbd65e9e3baa9406d027f3	MARCO	12261811645	NULL	12261811645	37761	ALCOOL ETILICO 70 % ST TP ML	0.0300	0.0200	0.0100	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	9ffbbf7340bbd65e9e3baa9406d027f3	MARCO	12261811645	NULL	12261811645	33219	LUVA DE PROCEDIMENTO UNIDADE UN	1.0000	0.6700	0.3300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	9ffbbf7340bbd65e9e3baa9406d027f3	MARCO	12261811645	NULL	12261811645	37761	ALCOOL ETILICO 70 % ST TP ML	0.0300	0.0200	0.0100	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	9ffbbf7340bbd65e9e3baa9406d027f3	MARCO	12261811645	NULL	12261811645	00817	ALGODAO HIDROFILO BOLINHA UN	0.2600	0.1300	0.1300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	9ffbbf7340bbd65e9e3baa9406d027f3	MARCO	12261811645	NULL	12261811645	00817	ALGODAO HIDROFILO BOLINHA UN	0.2600	0.1300	0.1300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	9ffbbf7340bbd65e9e3baa9406d027f3	MARCO	12261811645	NULL	12261811645	37761	ALCOOL ETILICO 70 % ST TP ML	0.0300	0.0200	0.0100	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	9ffbbf7340bbd65e9e3baa9406d027f3	MARCO	12261811645	NULL	12261811645	37761	ALCOOL ETILICO 70 % ST TP ML	0.0300	0.0200	0.0100	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	9ffbbf7340bbd65e9e3baa9406d027f3	MARCO	12261811645	NULL	12261811645	33219	LUVA DE PROCEDIMENTO UNIDADE UN	1.0000	0.6700	0.3300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	9ffbbf7340bbd65e9e3baa9406d027f3	MARCO	12261811645	NULL	12261811645	37761	ALCOOL ETILICO 70 % ST TP ML	0.0300	0.0200	0.0100	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	f15dde67c6bce10519b3c6376759939c	JOAO	12625226846	NULL	12625226846	08664	ESPARADRAPO MICROPORE 50 X 10 CM CM	2.5600	1.0200	1.5400	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	33219	LUVA DE PROCEDIMENTO UNIDADE UN	1.0000	0.6700	0.3300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	00817	ALGODAO HIDROFILO BOLINHA UN	0.2600	0.1300	0.1300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	53660	EQUIPO MACRO-GOTAS FLEXIVEL C/ INJETOR LATE	1.5900	0.0000	1.5900	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	33219	LUVA DE PROCEDIMENTO UNIDADE UN	1.0000	0.6700	0.3300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	37761	ALCOOL ETILICO 70 % ST TP ML	0.0600	0.0300	0.0300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	05975	COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER	0.0600	0.0000	0.0600	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	08648	ESPARADRAPO 10 X 4.5 CM CM	0.4000	0.0000	0.4000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	05444	CLORETO DE POTASSIO 15% 10 ML SI IV AP	1.3700	1.0300	0.3400	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	00817	ALGODAO HIDROFILO BOLINHA UN	0.5100	0.2600	0.2500	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	02720	BOLSA COLETORA (SISTEMA ABERTO) UN	1.2800	0.9600	0.3200	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	a39fe8b0276da428395df4da4f2b1537	JOSE	12442708440	NULL	12442708440	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1765	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a39fe8b0276da428395df4da4f2b1537	JOSE	12442708440	NULL	12442708440	29020166	Nebulização Simples com Broncodilatador	0.0000	1.1700	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a39fe8b0276da428395df4da4f2b1537	JOSE	12442708440	NULL	12442708440	26981	SORO FISIOLOGICO 0,9% 10 ML SI IV AP	0.0000	0.1400	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a39fe8b0276da428395df4da4f2b1537	JOSE	12442708440	NULL	12442708440	26981	SORO FISIOLOGICO 0,9% 10 ML SI IV AP	0.0000	0.1400	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a39fe8b0276da428395df4da4f2b1537	JOSE	12442708440	NULL	12442708440	25040014	Fisioterapia Respiratória - em Doente Clínico Internado	0.0000	50.2800	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a39fe8b0276da428395df4da4f2b1537	JOSE	12442708440	NULL	12442708440	20691	HIDROCORTISONA 100 MG PO IM IV FA	0.0000	2.8300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a39fe8b0276da428395df4da4f2b1537	JOSE	12442708440	NULL	12442708440	20691	HIDROCORTISONA 100 MG PO IM IV FA	0.0000	2.8300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a39fe8b0276da428395df4da4f2b1537	JOSE	12442708440	NULL	12442708440	20691	HIDROCORTISONA 100 MG PO IM IV FA	0.0000	2.8300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a39fe8b0276da428395df4da4f2b1537	JOSE	12442708440	NULL	12442708440	01691	NISTATINA 100.000 UI/ML SU VO ML	0.0000	0.2950	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a39fe8b0276da428395df4da4f2b1537	JOSE	12442708440	NULL	12442708440	01691	NISTATINA 100.000 UI/ML SU VO ML	0.0000	0.2950	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a39fe8b0276da428395df4da4f2b1537	JOSE	12442708440	NULL	12442708440	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a39fe8b0276da428395df4da4f2b1537	JOSE	12442708440	NULL	12442708440	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a39fe8b0276da428395df4da4f2b1537	JOSE	12442708440	NULL	12442708440	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a39fe8b0276da428395df4da4f2b1537	JOSE	12442708440	NULL	12442708440	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a39fe8b0276da428395df4da4f2b1537	JOSE	12442708440	NULL	12442708440	00128	LUVA DE PROCEDIMENTO UNIDADE UN	0.0000	0.1665	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a39fe8b0276da428395df4da4f2b1537	JOSE	12442708440	NULL	12442708440	00128	LUVA DE PROCEDIMENTO UNIDADE UN	0.0000	1.6700	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a39fe8b0276da428395df4da4f2b1537	JOSE	12442708440	NULL	12442708440	00380	SALBUTAMOL 100 MCG SY VO DS	NULL	0.0000	NULL	OPME INVALIDO	2201
Glosa Min	2018-10-03 00:00:00.000000	1084117	a39fe8b0276da428395df4da4f2b1537	JOSE	12442708440	NULL	12442708440	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1765	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a39fe8b0276da428395df4da4f2b1537	JOSE	12442708440	NULL	12442708440	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1765	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a39fe8b0276da428395df4da4f2b1537	JOSE	12442708440	NULL	12442708440	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1765	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a39fe8b0276da428395df4da4f2b1537	JOSE	12442708440	NULL	12442708440	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1765	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a39fe8b0276da428395df4da4f2b1537	JOSE	12442708440	NULL	12442708440	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1765	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a39fe8b0276da428395df4da4f2b1537	JOSE	12442708440	NULL	12442708440	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1765	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a39fe8b0276da428395df4da4f2b1537	JOSE	12442708440	NULL	12442708440	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1765	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a39fe8b0276da428395df4da4f2b1537	JOSE	12442708440	NULL	12442708440	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1765	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a39fe8b0276da428395df4da4f2b1537	JOSE	12442708440	NULL	12442708440	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1765	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a39fe8b0276da428395df4da4f2b1537	JOSE	12442708440	NULL	12442708440	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1765	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a39fe8b0276da428395df4da4f2b1537	JOSE	12442708440	NULL	12442708440	51241	AGULHA 123X45	0.0000	0.1900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a39fe8b0276da428395df4da4f2b1537	JOSE	12442708440	NULL	12442708440	51241	AGULHA 123X45	0.0000	0.1900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a39fe8b0276da428395df4da4f2b1537	JOSE	12442708440	NULL	12442708440	51588	ESPARADRAPO MICROPORE 50 X 10 CM CM	0.0000	0.5400	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a39fe8b0276da428395df4da4f2b1537	JOSE	12442708440	NULL	12442708440	51659	FENOTEROL 2 MG/ML 10 ML AE IN DS	0.0000	0.2567	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a39fe8b0276da428395df4da4f2b1537	JOSE	12442708440	NULL	12442708440	00090	SERINGA DESC 20 ML UN	0.0000	0.5375	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a39fe8b0276da428395df4da4f2b1537	JOSE	12442708440	NULL	12442708440	00090	SERINGA DESC 20 ML UN	0.0000	0.5373	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a39fe8b0276da428395df4da4f2b1537	JOSE	12442708440	NULL	12442708440	00090	SERINGA DESC 20 ML UN	0.0000	0.5373	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a39fe8b0276da428395df4da4f2b1537	JOSE	12442708440	NULL	12442708440	00090	SERINGA DESC 20 ML UN	0.0000	0.5373	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a39fe8b0276da428395df4da4f2b1537	JOSE	12442708440	NULL	12442708440	00090	SERINGA DESC 20 ML UN	0.0000	0.5373	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a39fe8b0276da428395df4da4f2b1537	JOSE	12442708440	NULL	12442708440	00090	SERINGA DESC 20 ML UN	0.0000	0.5373	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a39fe8b0276da428395df4da4f2b1537	JOSE	12442708440	NULL	12442708440	00090	SERINGA DESC 20 ML UN	0.0000	0.5373	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	61e4786d45edfdbf19b77fb2c6ce6b9c	REINALDO	12754482747	NULL	12754482747	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	61e4786d45edfdbf19b77fb2c6ce6b9c	REINALDO	12754482747	NULL	12754482747	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	61e4786d45edfdbf19b77fb2c6ce6b9c	REINALDO	12754482747	NULL	12754482747	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	61e4786d45edfdbf19b77fb2c6ce6b9c	REINALDO	12754482747	NULL	12754482747	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	61e4786d45edfdbf19b77fb2c6ce6b9c	REINALDO	12754482747	NULL	12754482747	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	61e4786d45edfdbf19b77fb2c6ce6b9c	REINALDO	12754482747	NULL	12754482747	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	61e4786d45edfdbf19b77fb2c6ce6b9c	REINALDO	12754482747	NULL	12754482747	51589	ESPARADRAPO 10 X 4.5 CM CM	0.0000	0.4000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	61e4786d45edfdbf19b77fb2c6ce6b9c	REINALDO	12754482747	NULL	12754482747	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	61e4786d45edfdbf19b77fb2c6ce6b9c	REINALDO	12754482747	NULL	12754482747	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	61e4786d45edfdbf19b77fb2c6ce6b9c	REINALDO	12754482747	NULL	12754482747	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	61e4786d45edfdbf19b77fb2c6ce6b9c	REINALDO	12754482747	NULL	12754482747	00881	DEXCLORFENIRAMINA 2 MG CP VO UN	0.0000	0.3300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4072	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4072	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	00090	SERINGA DESC 20 ML UN	0.0000	0.5343	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	00090	SERINGA DESC 20 ML UN	0.0000	0.5371	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	00090	SERINGA DESC 20 ML UN	0.0000	0.5371	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	00090	SERINGA DESC 20 ML UN	0.0000	0.5371	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	00090	SERINGA DESC 20 ML UN	0.0000	0.5371	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	00090	SERINGA DESC 20 ML UN	0.0000	0.5371	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	00090	SERINGA DESC 20 ML UN	0.0000	0.5371	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	00090	SERINGA DESC 20 ML UN	0.0000	0.5371	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	00090	SERINGA DESC 20 ML UN	0.0000	0.5371	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	00090	SERINGA DESC 20 ML UN	0.0000	0.5371	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	00090	SERINGA DESC 20 ML UN	0.0000	0.5371	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	00090	SERINGA DESC 20 ML UN	0.0000	0.5371	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	00090	SERINGA DESC 20 ML UN	0.0000	0.5371	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	081fdadb830fb547e83c43fabdb88372	ELZA	12377335349	NULL	12377335349	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	081fdadb830fb547e83c43fabdb88372	ELZA	12377335349	NULL	12377335349	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	081fdadb830fb547e83c43fabdb88372	ELZA	12377335349	NULL	12377335349	01611	CLORETO DE POTASSIO 600 MG CA VO UN	0.0000	0.4900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	081fdadb830fb547e83c43fabdb88372	ELZA	12377335349	NULL	12377335349	01611	CLORETO DE POTASSIO 600 MG CA VO UN	0.0000	0.4900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	081fdadb830fb547e83c43fabdb88372	ELZA	12377335349	NULL	12377335349	01611	CLORETO DE POTASSIO 600 MG CA VO UN	0.0000	0.4900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	081fdadb830fb547e83c43fabdb88372	ELZA	12377335349	NULL	12377335349	01611	CLORETO DE POTASSIO 600 MG CA VO UN	0.0000	0.4900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	081fdadb830fb547e83c43fabdb88372	ELZA	12377335349	NULL	12377335349	25040014	Fisioterapia Respiratória - em Doente Clínico Internado	0.0000	0.3500	NULL	EXAME SEM REGISTRO DE EXECUCAO	2703
Glosa Min	2018-10-03 00:00:00.000000	1084117	081fdadb830fb547e83c43fabdb88372	ELZA	12377335349	NULL	12377335349	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1800	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	081fdadb830fb547e83c43fabdb88372	ELZA	12377335349	NULL	12377335349	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1800	NULL	PAGO CONFORME RELATORIO DE AUDITORIA EXTERNA ― CONTA INICIAL	1717
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.0000	0.6860	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	51379	SERINGA DESC 05 ML UN	0.0000	0.1900	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	51379	SERINGA DESC 05 ML UN	0.0000	0.1900	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	51379	SERINGA DESC 05 ML UN	0.0000	0.1900	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	51379	SERINGA DESC 05 ML UN	0.0000	0.1900	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	51379	SERINGA DESC 05 ML UN	0.0000	0.1900	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	51379	SERINGA DESC 05 ML UN	0.0000	0.1900	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	51379	SERINGA DESC 05 ML UN	0.0000	0.1900	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	51588	ESPARADRAPO MICROPORE 50 X 10 CM CM	0.0000	0.7700	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	345c226bfea274af1372d41b0305a6c8	ALTINO	12720257940	NULL	12720257940	25722	OMEPRAZOL 40 MG + DIL. 10 ML PO IV FA	0.0000	0.0000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	345c226bfea274af1372d41b0305a6c8	ALTINO	12720257940	NULL	12720257940	25722	OMEPRAZOL 40 MG + DIL. 10 ML PO IV FA	0.0000	6.9300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	345c226bfea274af1372d41b0305a6c8	ALTINO	12720257940	NULL	12720257940	00172	SORO FISIOLOGICO 0,9% 500 ML SI IV BS	0.0000	0.0000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	345c226bfea274af1372d41b0305a6c8	ALTINO	12720257940	NULL	12720257940	00493	BROMOPRIDA 5 MG/ML 2 ML SI IM IV AP	0.0000	2.7300	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	345c226bfea274af1372d41b0305a6c8	ALTINO	12720257940	NULL	12720257940	00493	BROMOPRIDA 5 MG/ML 2 ML SI IM IV AP	0.0000	2.7300	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	dd486d36a88cfef0b44fe652638a0164	DELFINA	12660326244	NULL	12660326244	00127	LUVA DE PROCEDIMENTO UNIDADE UN	0.0000	0.6700	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	dd486d36a88cfef0b44fe652638a0164	DELFINA	12660326244	NULL	12660326244	00128	LUVA DE PROCEDIMENTO UNIDADE UN	0.0000	1.0000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	dd486d36a88cfef0b44fe652638a0164	DELFINA	12660326244	NULL	12660326244	00128	LUVA DE PROCEDIMENTO UNIDADE UN	0.0000	1.0000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	dd486d36a88cfef0b44fe652638a0164	DELFINA	12660326244	NULL	12660326244	00128	LUVA DE PROCEDIMENTO UNIDADE UN	0.0000	1.0000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	dd486d36a88cfef0b44fe652638a0164	DELFINA	12660326244	NULL	12660326244	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	dd486d36a88cfef0b44fe652638a0164	DELFINA	12660326244	NULL	12660326244	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	dd486d36a88cfef0b44fe652638a0164	DELFINA	12660326244	NULL	12660326244	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	dd486d36a88cfef0b44fe652638a0164	DELFINA	12660326244	NULL	12660326244	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	dd486d36a88cfef0b44fe652638a0164	DELFINA	12660326244	NULL	12660326244	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	dd486d36a88cfef0b44fe652638a0164	DELFINA	12660326244	NULL	12660326244	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	dd486d36a88cfef0b44fe652638a0164	DELFINA	12660326244	NULL	12660326244	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	dd486d36a88cfef0b44fe652638a0164	DELFINA	12660326244	NULL	12660326244	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	dd486d36a88cfef0b44fe652638a0164	DELFINA	12660326244	NULL	12660326244	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	dd486d36a88cfef0b44fe652638a0164	DELFINA	12660326244	NULL	12660326244	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	dd486d36a88cfef0b44fe652638a0164	DELFINA	12660326244	NULL	12660326244	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	dd486d36a88cfef0b44fe652638a0164	DELFINA	12660326244	NULL	12660326244	00090	SERINGA DESC 20 ML UN	0.0000	0.5400	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	dd486d36a88cfef0b44fe652638a0164	DELFINA	12660326244	NULL	12660326244	00090	SERINGA DESC 20 ML UN	0.0000	0.5400	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	dd486d36a88cfef0b44fe652638a0164	DELFINA	12660326244	NULL	12660326244	00919	ALGODAO HIDROFILO BOLINHA UN	0.0000	0.2600	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	01652	TRAMADOL 50 MG CP VO UN	0.0000	1.9300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.0000	0.6900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.0000	0.6875	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.0000	0.6875	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.0000	0.6900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.0000	0.6900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.0000	0.6900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.0000	0.6900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.0000	0.6900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.0000	0.8100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1800	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1800	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1800	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	51589	ESPARADRAPO 10 X 4.5 CM CM	0.0000	0.4000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3fb5c891f31bb9efcb05395066127c52	ALAIDE	12636273441	NULL	12636273441	00487	RANITIDINA 25 MG/ML 2 ML SI IM IV AP	0.0000	0.0000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	610c198ec4c064687cf0524f147d3aed	ROBERTO	12748814743	NULL	12748814743	16322	BENZILPENICILINA POTASSICA CRIST. 5.000.000	8.0700	8.0685	0.0017	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	610c198ec4c064687cf0524f147d3aed	ROBERTO	12748814743	NULL	12748814743	16322	BENZILPENICILINA POTASSICA CRIST. 5.000.000	8.0700	8.0683	0.0017	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	51378	SERINGA DESC 03 ML UN	0.1500	0.0600	0.0900	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	51378	SERINGA DESC 03 ML UN	0.1500	0.0600	0.0900	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00127	LUVA DE PROCEDIMENTO UNIDADE UN	0.3300	0.1300	0.2000	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00127	LUVA DE PROCEDIMENTO UNIDADE UN	0.3300	0.1300	0.2000	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00127	LUVA DE PROCEDIMENTO UNIDADE UN	0.3300	0.1300	0.2000	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.4000	0.1600	0.2400	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.4000	0.1600	0.2400	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.4000	0.1600	0.2400	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.4000	0.1600	0.2400	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.4000	0.1600	0.2400	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.4000	0.1600	0.2400	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.4000	0.1600	0.2400	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.4000	0.1600	0.2400	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00020010	Visita Hospitalar (Paciente Internado)	43.8000	17.1000	26.7000	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	07802	PIPERACILINA 4 G + TAZOBACTAM 500 MG PO IV FA	83.4500	32.5900	50.8600	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	54175	DIETA SEMI ELEMENTAR 1.0 KCAL/ML EM EN ML	86.4000	33.7400	52.6600	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	54178	DIETA SEMI ELEMENTAR C/ IMUNOMODDULADORES 1.5 KCA	115.2000	44.9800	70.2200	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	01081197	5125859e8d2860b83822c41756a9b5bf	ESMERALDA	12734516820	NULL	12734516820...	32010028	RX Crânio: P.A. - Lat.- Bretton	0.0000	0.0060	NULL	EXAME SEM REGISTRO DE EXECUCAO	2703
Glosa Min	2018-10-03 00:00:00.000000	01081197	e0b1f77dc9cff210f2fbead99c7ba4d4	MARCIO	12790052920	NULL	12790052920	00097	ABOCATH N 14 A 22 UN	NULL	0.0000	NULL	OPME INVALIDO	2201
Glosa Min	2018-10-03 00:00:00.000000	01081197	3af14fcc4f764a77ed38b3d2e81bcc76	JOAO	12687535922	NULL	12687535922	53895	OMNIPAQUE (IOEXOL) 300 MG/IML SI IT IV VO ML	NULL	0.0000	NULL	OPME INVALIDO	2201
Glosa Min	2018-10-03 00:00:00.000000	01081197	3af14fcc4f764a77ed38b3d2e81bcc76	JOAO	12687535922	NULL	12687535922	00097	ABOCATH N 14 A 22 UN	NULL	0.0000	NULL	OPME INVALIDO	2201
Glosa Min	2018-10-03 00:00:00.000000	1084117	16b1e9f62f247f02ad5cac910ee15b4e	BERCHOLINA	12631612848	NULL	12631612848	00171	SORO FISIOLOGICO 0,9% 250 ML SI IV BS	3.9400	3.7600	0.1800	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	16b1e9f62f247f02ad5cac910ee15b4e	BERCHOLINA	12631612848	NULL	12631612848	04073	TRAMADOL 50 MG 1 ML SI IM IV AP	4.1900	4.0000	0.1900	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	16b1e9f62f247f02ad5cac910ee15b4e	BERCHOLINA	12631612848	NULL	12631612848	04073	TRAMADOL 50 MG 1 ML SI IM IV AP	4.1900	4.0000	0.1900	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	16b1e9f62f247f02ad5cac910ee15b4e	BERCHOLINA	12631612848	NULL	12631612848	22421	PIPERACILINA 2 G + TAZOBACTAM 250 MG 30 ML PO IV	55.3400	52.7400	2.6000	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	16b1e9f62f247f02ad5cac910ee15b4e	BERCHOLINA	12631612848	NULL	12631612848	22421	PIPERACILINA 2 G + TAZOBACTAM 250 MG 30 ML PO IV	55.3400	52.7400	2.6000	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	16b1e9f62f247f02ad5cac910ee15b4e	BERCHOLINA	12631612848	NULL	12631612848	22421	PIPERACILINA 2 G + TAZOBACTAM 250 MG 30 ML PO IV	55.3400	52.7400	2.6000	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	16b1e9f62f247f02ad5cac910ee15b4e	BERCHOLINA	12631612848	NULL	12631612848	22421	PIPERACILINA 2 G + TAZOBACTAM 250 MG 30 ML PO IV	55.3400	52.7400	2.6000	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12579183644	NULL	12579183644	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.0000	0.1800	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12579183644	NULL	12579183644	02720	BOLSA COLETORA (SISTEMA ABERTO) UN	1.2800	0.6400	0.6400	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12579183644	NULL	12579183644	32204	CLORETO DE SODIO 0,9% 10 ML SI IV AP	0.9600	0.0000	0.9600	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12579183644	NULL	12579183644	32204	CLORETO DE SODIO 0,9% 10 ML SI IV AP	0.9600	0.0000	0.9600	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12579183644	NULL	12579183644	00485	AGUA BIDESTILADA 500 ML SI IM IV BS	6.4300	0.0000	6.4300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12579183644	NULL	12579183644	28959	DERSANI LC TP ML	19.4000	14.5500	4.8500	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12579183644	NULL	12579183644	37761	ALCOOL ETILICO 70 % ST TP ML	0.0600	0.0300	0.0300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12579183644	NULL	12579183644	28959	DERSANI LC TP ML	19.4000	14.5500	4.8500	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12579183644	NULL	12579183644	00485	AGUA BIDESTILADA 500 ML SI IM IV BS	6.4300	0.0000	6.4300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12579183644	NULL	12579183644	02720	BOLSA COLETORA (SISTEMA ABERTO) UN	1.2800	0.6400	0.6400	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	d17b3c5ae418d82694895a326dee545a	ODILIA	12670516743	NULL	12670516743	00817	ALGODAO HIDROFILO BOLINHA UN	0.2600	0.1300	0.1300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	d17b3c5ae418d82694895a326dee545a	ODILIA	12670516743	NULL	12670516743	00817	ALGODAO HIDROFILO BOLINHA UN	0.2600	0.1300	0.1300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	d17b3c5ae418d82694895a326dee545a	ODILIA	12670516743	NULL	12670516743	37761	ALCOOL ETILICO 70 % ST TP ML	0.0300	0.0200	0.0100	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	d17b3c5ae418d82694895a326dee545a	ODILIA	12670516743	NULL	12670516743	32204	CLORETO DE SODIO 0,9% 10 ML SI IV AP	0.9600	0.0000	0.9600	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	d17b3c5ae418d82694895a326dee545a	ODILIA	12670516743	NULL	12670516743	37761	ALCOOL ETILICO 70 % ST TP ML	0.0300	0.0200	0.0100	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	20cbe2e07b1dcd2b6af609a50df7ae80	LUCELENA	12690767849	NULL	12690767849	37761	ALCOOL ETILICO 70 % ST TP ML	0.0300	0.0200	0.0100	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	20cbe2e07b1dcd2b6af609a50df7ae80	LUCELENA	12690767849	NULL	12690767849	33219	LUVA DE PROCEDIMENTO UNIDADE UN	1.0000	0.6700	0.3300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	20cbe2e07b1dcd2b6af609a50df7ae80	LUCELENA	12690767849	NULL	12690767849	33219	LUVA DE PROCEDIMENTO UNIDADE UN	1.6700	0.6700	1.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	de1a8276d878171456d7fc8f6dcd2457	ABEL	12764206443	NULL	12764206443	58750	AGULHA P/ PUNÇAO PERCUTANEA UN	82.0000	0.0000	82.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	11193	CLOREXIDINA 2 % ST TP ML	0.4000	0.2700	0.1300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	20567	SORO FISIOLOGICO 0,9% 500 ML SI IV BS	4.7300	0.0000	4.7300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	32204	CLORETO DE SODIO 0,9% 10 ML SI IV AP	0.9600	0.0000	0.9600	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	37761	ALCOOL ETILICO 70 % ST TP ML	0.0300	0.0200	0.0100	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	53660	EQUIPO MACRO-GOTAS FLEXIVEL C/ INJETOR LATE	4.7700	0.0000	4.7700	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	34789	SONDA ASPIRAÇAO C/ VALVULA - TODAS - UTI UN	2.8100	1.8700	0.9400	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00817	ALGODAO HIDROFILO BOLINHA UN	0.5100	0.2600	0.2500	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00817	ALGODAO HIDROFILO BOLINHA UN	0.5100	0.2600	0.2500	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00817	ALGODAO HIDROFILO BOLINHA UN	0.5100	0.2600	0.2500	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00817	ALGODAO HIDROFILO BOLINHA UN	0.5100	0.2600	0.2500	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00817	ALGODAO HIDROFILO BOLINHA UN	0.5100	0.2600	0.2500	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00817	ALGODAO HIDROFILO BOLINHA UN	0.5100	0.2600	0.2500	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	752c651cb4fd049e19c685f87fbe8bdc	EDUARDO	12765990646	NULL	12765990646	32891	EQUIPO POLIFIX 2ş VIAS UN	2.5500	0.0000	2.5500	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	752c651cb4fd049e19c685f87fbe8bdc	EDUARDO	12765990646	NULL	12765990646	00817	ALGODAO HIDROFILO BOLINHA UN	0.5100	0.1300	0.3800	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	752c651cb4fd049e19c685f87fbe8bdc	EDUARDO	12765990646	NULL	12765990646	37761	ALCOOL ETILICO 70 % ST TP ML	0.0600	0.0200	0.0400	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	752c651cb4fd049e19c685f87fbe8bdc	EDUARDO	12765990646	NULL	12765990646	00817	ALGODAO HIDROFILO BOLINHA UN	0.5100	0.1300	0.3800	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3d5131ef222e15b77c298e3372afc496	MARIA	12665213047	NULL	12665213047	29700	HENETIX (IOBITRIDOL) 300 MG/ML SI IV ML	359.5000	179.7500	179.7500	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	33219	LUVA DE PROCEDIMENTO UNIDADE UN	1.0000	0.6700	0.3300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	37761	ALCOOL ETILICO 70 % ST TP ML	0.0300	0.0200	0.0100	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	345c226bfea274af1372d41b0305a6c8	ALTINO	12720257940	NULL	12720257940	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.1000	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	345c226bfea274af1372d41b0305a6c8	ALTINO	12720257940	NULL	12720257940	21822	TRAMADOL 50 MG 1 ML SI IM IV AP	4.1900	4.1900	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	345c226bfea274af1372d41b0305a6c8	ALTINO	12720257940	NULL	12720257940	07269	DIPIRONA 500 MG/ML 2 ML SI IV IM AP	0.6900	0.6860	0.0040	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	31d18d6607d9e742c53e748d6a55d740	CARLOS	12557779343	NULL	12557779343	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1760	0.0040	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	31d18d6607d9e742c53e748d6a55d740	CARLOS	12557779343	NULL	12557779343	07269	DIPIRONA 500 MG/ML 2 ML SI IV IM AP	0.6900	0.6860	0.0040	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	31d18d6607d9e742c53e748d6a55d740	CARLOS	12557779343	NULL	12557779343	07269	DIPIRONA 500 MG/ML 2 ML SI IV IM AP	0.6900	0.6860	0.0040	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	0405a686318e3fc262f105ed4be24d95	CARMELITA	12687161644	NULL	12687161644	07269	DIPIRONA 500 MG/ML 2 ML SI IV IM AP	0.6900	0.6873	0.0027	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	0405a686318e3fc262f105ed4be24d95	CARMELITA	12687161644	NULL	12687161644	07269	DIPIRONA 500 MG/ML 2 ML SI IV IM AP	0.6900	0.6873	0.0027	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	0405a686318e3fc262f105ed4be24d95	CARMELITA	12687161644	NULL	12687161644	07269	DIPIRONA 500 MG/ML 2 ML SI IV IM AP	0.6900	0.6873	0.0027	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	ea6abb4182a48f0934f3e9eb5affa056	DILVA	12697455440	NULL	12697455440	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1750	0.0050	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	ea6abb4182a48f0934f3e9eb5affa056	DILVA	12697455440	NULL	12697455440	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1750	0.0050	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	752c651cb4fd049e19c685f87fbe8bdc	EDUARDO	12765990646	NULL	12765990646	00817	ALGODAO HIDROFILO BOLINHA UN	0.5100	0.1300	0.3800	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	27600	ONDANSETRONA 2 MG/ML 4 ML SI IM IV AP	13.5300	0.0000	13.5300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	27600	ONDANSETRONA 2 MG/ML 4 ML SI IM IV AP	13.5300	0.0000	13.5300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	27600	ONDANSETRONA 2 MG/ML 4 ML SI IM IV AP	13.5300	0.0000	13.5300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	33219	LUVA DE PROCEDIMENTO UNIDADE UN	0.3300	0.0000	0.3300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	19135	SERINGA DESC 03 ML UN	0.1500	0.0000	0.1500	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	08664	ESPARADRAPO MICROPORE 50 X 10 CM CM	0.2600	0.2561	0.0039	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	dd6f8d6c53ffe9bfd3aa9590ba500cc8	ILDA	12751932542	NULL	12751932542	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.0000	1.3600	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1965b0cdebe9017c3397c8641147759	JOSE	12705413746	NULL	12705413746	00090	SERINGA DESC 20 ML UN	0.0000	0.5375	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1965b0cdebe9017c3397c8641147759	JOSE	12705413746	NULL	12705413746	00090	SERINGA DESC 20 ML UN	0.0000	0.5375	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1965b0cdebe9017c3397c8641147759	JOSE	12705413746	NULL	12705413746	00090	SERINGA DESC 20 ML UN	0.0000	0.5375	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1965b0cdebe9017c3397c8641147759	JOSE	12705413746	NULL	12705413746	51671	REPARIL (ESCINA + DIETILAMONIO) GL TP GR	0.0000	0.0000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1965b0cdebe9017c3397c8641147759	JOSE	12705413746	NULL	12705413746	51671	REPARIL (ESCINA + DIETILAMONIO) GL TP GR	0.0000	0.0000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1965b0cdebe9017c3397c8641147759	JOSE	12705413746	NULL	12705413746	51671	REPARIL (ESCINA + DIETILAMONIO) GL TP GR	0.0000	0.0000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1965b0cdebe9017c3397c8641147759	JOSE	12705413746	NULL	12705413746	51671	REPARIL (ESCINA + DIETILAMONIO) GL TP GR	0.0000	3.7500	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1965b0cdebe9017c3397c8641147759	JOSE	12705413746	NULL	12705413746	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1775	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1965b0cdebe9017c3397c8641147759	JOSE	12705413746	NULL	12705413746	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1775	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1965b0cdebe9017c3397c8641147759	JOSE	12705413746	NULL	12705413746	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1775	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1965b0cdebe9017c3397c8641147759	JOSE	12705413746	NULL	12705413746	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1775	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1965b0cdebe9017c3397c8641147759	JOSE	12705413746	NULL	12705413746	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1800	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1965b0cdebe9017c3397c8641147759	JOSE	12705413746	NULL	12705413746	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.0000	0.8074	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1965b0cdebe9017c3397c8641147759	JOSE	12705413746	NULL	12705413746	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.0000	0.8074	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1965b0cdebe9017c3397c8641147759	JOSE	12705413746	NULL	12705413746	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.0000	0.8074	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1965b0cdebe9017c3397c8641147759	JOSE	12705413746	NULL	12705413746	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.0000	0.8067	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1965b0cdebe9017c3397c8641147759	JOSE	12705413746	NULL	12705413746	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.0000	0.8067	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1965b0cdebe9017c3397c8641147759	JOSE	12705413746	NULL	12705413746	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.0000	0.8074	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1965b0cdebe9017c3397c8641147759	JOSE	12705413746	NULL	12705413746	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.0000	0.8074	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1965b0cdebe9017c3397c8641147759	JOSE	12705413746	NULL	12705413746	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.0000	0.8074	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1965b0cdebe9017c3397c8641147759	JOSE	12705413746	NULL	12705413746	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00090	SERINGA DESC 20 ML UN	0.0000	0.5375	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00090	SERINGA DESC 20 ML UN	0.0000	0.5375	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00090	SERINGA DESC 20 ML UN	0.0000	0.5375	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00090	SERINGA DESC 20 ML UN	0.0000	0.5375	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00090	SERINGA DESC 20 ML UN	0.0000	0.5375	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	54157	EQUIPO P/ DIETA ENTERAL UN	0.0000	1.7000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	51649	ALCOOL ETILICO 70 % ST TP ML	0.0000	0.0300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	51649	ALCOOL ETILICO 70 % ST TP ML	0.0000	0.0300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1776	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1776	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1776	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.0000	0.4000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.0000	0.4000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.0000	0.4000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00487	RANITIDINA 25 MG/ML 2 ML SI IM IV AP	0.0000	0.9300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00037	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	35382	COMPRESSAS DE GASES 7.5 X7,5 (11 FIOS ESTERIL) UN	0.0000	0.6000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.0000	0.6871	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.0000	0.6871	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.0000	0.6871	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	11325	EQUIPO MACRO-GOTAS FLEXIVEL C/ INJETOR LATERAL UN	0.0000	1.5900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	11325	EQUIPO MACRO-GOTAS FLEXIVEL C/ INJETOR LATERAL UN	0.0000	1.5900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	11325	EQUIPO MACRO-GOTAS FLEXIVEL C/ INJETOR LATERAL UN	0.0000	1.5900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	2e6b6f291f2df9beb1fbda6028678909	ANNA	12463693448	NULL	12463693448	09070	ACETILCISTEINA 600MG PO VO SA	0.0000	3.5000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	2e6b6f291f2df9beb1fbda6028678909	ANNA	12463693448	NULL	12463693448	09070	ACETILCISTEINA 600MG PO VO SA	0.0000	3.5000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	2e6b6f291f2df9beb1fbda6028678909	ANNA	12463693448	NULL	12463693448	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.0000	0.6900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	2e6b6f291f2df9beb1fbda6028678909	ANNA	12463693448	NULL	12463693448	29020166	Nebulização Simples com Broncodilatador	0.0000	4.6800	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	2e6b6f291f2df9beb1fbda6028678909	ANNA	12463693448	NULL	12463693448	29020166	Nebulização Simples com Broncodilatador	0.0000	4.8400	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	2e6b6f291f2df9beb1fbda6028678909	ANNA	12463693448	NULL	12463693448	00184	CLORETO DE POTASSIO 10% 10 ML SI IV AP	0.0000	0.3000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	2e6b6f291f2df9beb1fbda6028678909	ANNA	12463693448	NULL	12463693448	00184	CLORETO DE POTASSIO 10% 10 ML SI IV AP	0.0000	0.3000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00091	SERINGA DESC 01 ML (INSULINA) UN	0.0000	0.0000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00090	SERINGA DESC 20 ML UN	0.0000	0.5367	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00090	SERINGA DESC 20 ML UN	0.0000	0.5367	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00090	SERINGA DESC 20 ML UN	0.0000	0.5367	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00090	SERINGA DESC 20 ML UN	0.0000	0.5367	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00090	SERINGA DESC 20 ML UN	0.0000	0.5367	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00069	SERINGA DESC 10 ML UN	0.0000	0.6657	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	25030019	Distúrbios Circulatórios Artério - Venosos e Linfáticos	0.0000	45.8500	NULL	COBRANCA DE PROCEDIMENTO/EXAME SEM JUSTIFICATIVA PARA REALIZACAO OU COM JUSTIFICATIVA INSUFICIENTE	2705
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	02355	AMOXICILINA 1 G + CLAVULANATO 200 MG + DIL. 10 ML	0.0000	36.4667	NULL	COBRANCA DE MEDICAMENTO EM QUANTIDADE INCOMPATIVEL COM A PERMANENCIA	2107
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	02355	AMOXICILINA 1 G + CLAVULANATO 200 MG + DIL. 10 ML	0.0000	36.4667	NULL	COBRANCA DE MEDICAMENTO EM QUANTIDADE INCOMPATIVEL COM A PERMANENCIA	2107
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	02355	AMOXICILINA 1 G + CLAVULANATO 200 MG + DIL. 10 ML	0.0000	36.4667	NULL	COBRANCA DE MEDICAMENTO EM QUANTIDADE INCOMPATIVEL COM A PERMANENCIA	2107
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	01611	CLORETO DE POTASSIO 600 MG CA VO UN	0.0000	0.4870	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4072	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4072	NULL	COBRANCA DE MEDICAMENTO EM QUANTIDADE INCOMPATIVEL COM A PERMANENCIA	2107
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4072	NULL	COBRANCA DE MEDICAMENTO EM QUANTIDADE INCOMPATIVEL COM A PERMANENCIA	2107
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4072	NULL	COBRANCA DE MEDICAMENTO EM QUANTIDADE INCOMPATIVEL COM A PERMANENCIA	2107
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4072	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4072	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4072	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4072	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4072	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4072	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4072	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4072	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00124	LUVA CIRURGICA UN	0.0000	1.4475	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00124	LUVA CIRURGICA UN	0.0000	1.4475	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	15f461c0ca379f375bd9f8b18fbb101a	ANA	12753753845	NULL	12753753845	55279	TRAMADOL 50 MG 1 ML SI IM IV AP	0.0000	4.1900	NULL	COBRANCA DE MEDICAMENTO INCOMPATIVEL COM O RELATORIO TECNICO	2112
Glosa Min	2018-10-03 00:00:00.000000	1084117	15f461c0ca379f375bd9f8b18fbb101a	ANA	12753753845	NULL	12753753845	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR APRESENTADO A MAIOR	1705
Glosa Min	2018-10-03 00:00:00.000000	1084117	15f461c0ca379f375bd9f8b18fbb101a	ANA	12753753845	NULL	12753753845	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR APRESENTADO A MAIOR	1705
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	00919	ALGODAO HIDROFILO BOLINHA UN	0.0000	0.5100	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	09070	ACETILCISTEINA 600MG PO VO SA	0.0000	3.5000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	09070	ACETILCISTEINA 600MG PO VO SA	0.0000	3.5000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	54653	DERSANI LC TP ML	0.0000	9.7048	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	52392	SONDA DE ASPIRAÇAO TRAQUEAL C/ VALVULA UN	0.0000	0.9352	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	52392	SONDA DE ASPIRAÇAO TRAQUEAL C/ VALVULA UN	0.0000	0.9352	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	26981	SORO FISIOLOGICO 0,9% 10 ML SI IV AP	0.0000	0.9600	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	26981	SORO FISIOLOGICO 0,9% 10 ML SI IV AP	0.0000	0.9600	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	26981	SORO FISIOLOGICO 0,9% 10 ML SI IV AP	0.0000	0.9600	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	26981	SORO FISIOLOGICO 0,9% 10 ML SI IV AP	0.0000	0.9600	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	26981	SORO FISIOLOGICO 0,9% 10 ML SI IV AP	0.0000	0.9600	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	26981	SORO FISIOLOGICO 0,9% 10 ML SI IV AP	0.0000	0.9600	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	26981	SORO FISIOLOGICO 0,9% 10 ML SI IV AP	0.0000	0.9600	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	26981	SORO FISIOLOGICO 0,9% 10 ML SI IV AP	0.0000	0.9600	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	26981	SORO FISIOLOGICO 0,9% 10 ML SI IV AP	0.0000	0.4800	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	26981	SORO FISIOLOGICO 0,9% 10 ML SI IV AP	0.0000	0.4800	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	26981	SORO FISIOLOGICO 0,9% 10 ML SI IV AP	0.0000	0.4800	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	26981	SORO FISIOLOGICO 0,9% 10 ML SI IV AP	0.0000	0.4800	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	02246	HIDROCORTISONA 100 MG PO IM IV FA	0.0000	2.8300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	02246	HIDROCORTISONA 100 MG PO IM IV FA	0.0000	2.8300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	02246	HIDROCORTISONA 100 MG PO IM IV FA	0.0000	2.8300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	01496	FENITOINA 50 MG/ML 5 ML SI IM IV AP	0.0000	2.3400	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	01496	FENITOINA 50 MG/ML 5 ML SI IM IV AP	0.0000	2.3400	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	01496	FENITOINA 50 MG/ML 5 ML SI IM IV AP	0.0000	2.3400	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	01496	FENITOINA 50 MG/ML 5 ML SI IM IV AP	0.0000	2.3400	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	01496	FENITOINA 50 MG/ML 5 ML SI IM IV AP	0.0000	2.3400	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	01496	FENITOINA 50 MG/ML 5 ML SI IM IV AP	0.0000	2.3400	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	01496	FENITOINA 50 MG/ML 5 ML SI IM IV AP	0.0000	2.3400	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4094	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4094	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4094	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	9ffbbf7340bbd65e9e3baa9406d027f3	MARCO	12261811645	NULL	12261811645	00090	SERINGA DESC 20 ML UN	0.0000	0.5376	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	9ffbbf7340bbd65e9e3baa9406d027f3	MARCO	12261811645	NULL	12261811645	00090	SERINGA DESC 20 ML UN	0.0000	0.5376	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	9ffbbf7340bbd65e9e3baa9406d027f3	MARCO	12261811645	NULL	12261811645	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	9ffbbf7340bbd65e9e3baa9406d027f3	MARCO	12261811645	NULL	12261811645	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1773	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	9ffbbf7340bbd65e9e3baa9406d027f3	MARCO	12261811645	NULL	12261811645	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1773	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	9ffbbf7340bbd65e9e3baa9406d027f3	MARCO	12261811645	NULL	12261811645	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1773	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	9ffbbf7340bbd65e9e3baa9406d027f3	MARCO	12261811645	NULL	12261811645	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1773	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	9ffbbf7340bbd65e9e3baa9406d027f3	MARCO	12261811645	NULL	12261811645	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1773	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	9ffbbf7340bbd65e9e3baa9406d027f3	MARCO	12261811645	NULL	12261811645	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1773	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	9ffbbf7340bbd65e9e3baa9406d027f3	MARCO	12261811645	NULL	12261811645	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.0000	0.8078	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	9ffbbf7340bbd65e9e3baa9406d027f3	MARCO	12261811645	NULL	12261811645	02246	HIDROCORTISONA 100 MG PO IM IV FA	0.0000	2.8300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	9ffbbf7340bbd65e9e3baa9406d027f3	MARCO	12261811645	NULL	12261811645	01611	CLORETO DE POTASSIO 600 MG CA VO UN	0.0000	0.4867	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	9ffbbf7340bbd65e9e3baa9406d027f3	MARCO	12261811645	NULL	12261811645	01611	CLORETO DE POTASSIO 600 MG CA VO UN	0.0000	0.4867	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	9ffbbf7340bbd65e9e3baa9406d027f3	MARCO	12261811645	NULL	12261811645	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	9ffbbf7340bbd65e9e3baa9406d027f3	MARCO	12261811645	NULL	12261811645	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12550571048	NULL	12550571048	00090	SERINGA DESC 20 ML UN	0.0000	0.5379	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12550571048	NULL	12550571048	00090	SERINGA DESC 20 ML UN	0.0000	0.5379	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12550571048	NULL	12550571048	00090	SERINGA DESC 20 ML UN	0.0000	0.5379	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	4c68006246c347121db1f06edf5e5051	MARIA	12734155245	NULL	12734155245	00172	SORO FISIOLOGICO 0,9% 500 ML SI IV BS	0.0000	4.7300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	cd2840524be5a3f1d0939f241e24f32b	MARIA	12705908340	NULL	12705908340	00090	SERINGA DESC 20 ML UN	0.0000	0.5367	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	cd2840524be5a3f1d0939f241e24f32b	MARIA	12705908340	NULL	12705908340	55060153	Toracotomia com Drenagem Fechada	0.0000	1.7100	NULL	COBRANCA DE HONORARIOS EM DUPLICIDADE	2607
Glosa Min	2018-10-03 00:00:00.000000	1084117	cd2840524be5a3f1d0939f241e24f32b	MARIA	12705908340	NULL	12705908340	00487	RANITIDINA 25 MG/ML 2 ML SI IM IV AP	0.0000	0.9300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	cd2840524be5a3f1d0939f241e24f32b	MARIA	12705908340	NULL	12705908340	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	cd2840524be5a3f1d0939f241e24f32b	MARIA	12705908340	NULL	12705908340	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	cd2840524be5a3f1d0939f241e24f32b	MARIA	12705908340	NULL	12705908340	00184	CLORETO DE POTASSIO 10% 10 ML SI IV AP	0.0000	0.2967	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	cd2840524be5a3f1d0939f241e24f32b	MARIA	12705908340	NULL	12705908340	00184	CLORETO DE POTASSIO 10% 10 ML SI IV AP	0.0000	0.2967	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	cd2840524be5a3f1d0939f241e24f32b	MARIA	12705908340	NULL	12705908340	00181	SULFATO DE MAGNESIO 100 MG/ML 10 ML SI IM IV	0.0000	0.9467	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	cd2840524be5a3f1d0939f241e24f32b	MARIA	12705908340	NULL	12705908340	00181	SULFATO DE MAGNESIO 100 MG/ML 10 ML SI IM IV	0.0000	0.9464	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	52303	NOREPINEFRINA 2 MG/ML 4 ML SI IV AP	0.0000	66.4700	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	52303	NOREPINEFRINA 2 MG/ML 4 ML SI IV AP	0.0000	56.9800	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	52303	NOREPINEFRINA 2 MG/ML 4 ML SI IV AP	0.0000	56.9800	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	51584	ESPARADRAPO MICROPORE	0.0000	0.2560	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	51584	ESPARADRAPO MICROPORE	0.0000	0.2560	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	51584	ESPARADRAPO MICROPORE	0.0000	0.2560	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	51584	ESPARADRAPO MICROPORE	0.0000	0.2560	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	51508	ENCRISE (ARGIPRESSINA) 20 U/ML 1 ML SI IM IV SC AP	0.0000	20.1200	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.0000	0.4000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	00487	RANITIDINA 25 MG/ML 2 ML SI IM IV AP	0.0000	0.9300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	22421	PIPERACILINA 2 G + TAZOBACTAM 250 MG 30 ML PO IV	0.0000	55.3400	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	00170	SORO GLICOSADO 5% 250 ML SI IV BS	0.0000	6.7900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4070	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4070	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4070	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4070	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1766	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1766	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1800	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	36010014	Rm de Crânio	0.0000	0.0000	NULL	EXAME SEM REGISTRO DE EXECUCAO	2703
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.0000	0.6872	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.0000	0.6872	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.0000	0.6872	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.0000	0.6872	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.0000	0.6872	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.0000	0.6872	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4088	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4088	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4088	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4088	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4088	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4088	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4088	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00796	FLORATIL (SACCHAROMYCES BOULARDII) 200 MG PO VO	0.0000	4.4400	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	55030165	Desobstrução Traqueal a Laser	0.0000	0.0000	NULL	COBRANCA DE HONORARIOS EM DUPLICIDADE	2607
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	54995	EQUIPO P/ BOMBA DE INFUSAO ENTERAL / PARENTERAL U UN	0.0000	1.7485	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	54756	HIDANTAL	0.0000	0.1860	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	51584	ESPARADRAPO MICROPORE	0.0000	0.2560	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	51584	ESPARADRAPO MICROPORE	0.0000	0.2560	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	51584	ESPARADRAPO MICROPORE	0.0000	0.2600	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	51578	Frasco p/ alimentacao enteral	0.0000	2.4700	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	51419	FILTRO DE BARREIRA	0.0000	2.9900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	51379	SERINGA DESC 05 ML UN	0.0000	0.1900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00487	RANITIDINA 25 MG/ML 2 ML SI IM IV AP	0.0000	2.8000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00487	RANITIDINA 25 MG/ML 2 ML SI IM IV AP	0.0000	0.9300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.0000	0.6875	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.0000	0.6875	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.0000	0.6875	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	26981	SORO FISIOLOGICO 0,9% 10 ML SI IV AP	0.0000	0.9600	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	26981	SORO FISIOLOGICO 0,9% 10 ML SI IV AP	0.0000	0.9600	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	26981	SORO FISIOLOGICO 0,9% 10 ML SI IV AP	0.0000	0.9600	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	24082	BROMOPRIDA 5 MG/ML 2 ML SI IM IV AP	0.0000	2.7300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00124	LUVA CIRURGICA UN	0.0000	1.4475	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	75bcd473a0dc7c7a6751499b38a4a034	JOAQUIM	12692852143	NULL	12692852143	51710	CLORETO DE POTASSIO 15% 10 ML SI IV AP	0.0000	0.6850	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	75bcd473a0dc7c7a6751499b38a4a034	JOAQUIM	12692852143	NULL	12692852143	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.0000	0.6850	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	75bcd473a0dc7c7a6751499b38a4a034	JOAQUIM	12692852143	NULL	12692852143	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.0000	0.6850	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	75bcd473a0dc7c7a6751499b38a4a034	JOAQUIM	12692852143	NULL	12692852143	21010218	Painel de imuno - Histoquímica (Imunoperoxidase e Imunofluorescência) para Diagnóstico Diferencial de Neoplasias	0.0000	0.0000	NULL	COBRANCA DE HONORARIOS EM DUPLICIDADE	2607
Glosa Min	2018-10-03 00:00:00.000000	1084117	75bcd473a0dc7c7a6751499b38a4a034	JOAQUIM	12692852143	NULL	12692852143	00172	SORO FISIOLOGICO 0,9% 500 ML SI IV BS	0.0000	4.7300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	75bcd473a0dc7c7a6751499b38a4a034	JOAQUIM	12692852143	NULL	12692852143	00172	SORO FISIOLOGICO 0,9% 500 ML SI IV BS	0.0000	4.7300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	75bcd473a0dc7c7a6751499b38a4a034	JOAQUIM	12692852143	NULL	12692852143	01652	TRAMADOL 50 MG CP VO UN	0.0000	1.9272	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	75bcd473a0dc7c7a6751499b38a4a034	JOAQUIM	12692852143	NULL	12692852143	01652	TRAMADOL 50 MG CP VO UN	0.0000	1.9272	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	75bcd473a0dc7c7a6751499b38a4a034	JOAQUIM	12692852143	NULL	12692852143	01652	TRAMADOL 50 MG CP VO UN	0.0000	1.9272	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	75bcd473a0dc7c7a6751499b38a4a034	JOAQUIM	12692852143	NULL	12692852143	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4075	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	75bcd473a0dc7c7a6751499b38a4a034	JOAQUIM	12692852143	NULL	12692852143	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4075	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	75bcd473a0dc7c7a6751499b38a4a034	JOAQUIM	12692852143	NULL	12692852143	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	4e13adf421809cb755e1bdd80cc4efed	AGRIPINA	12385409142	NULL	12385409142	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	4e13adf421809cb755e1bdd80cc4efed	AGRIPINA	12385409142	NULL	12385409142	51649	ALCOOL ETILICO 70 % ST TP ML	0.0000	0.0300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	4e13adf421809cb755e1bdd80cc4efed	AGRIPINA	12385409142	NULL	12385409142	35382	COMPRESSAS DE GASES 7.5 X7,5 (11 FIOS ESTERIL) UN	0.0000	0.0300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	4e13adf421809cb755e1bdd80cc4efed	AGRIPINA	12385409142	NULL	12385409142	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	35382	COMPRESSAS DE GASES 7.5 X7,5 (11 FIOS ESTERIL) UN	0.0000	0.0000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00613	CLINDAMICINA 600 MG 4 ML SI IM IV AP	0.0000	13.0800	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	51708	Dieta Hipercalorica Hiperproteica Sem Fibras 1.5 kcal	0.0000	73.4000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	51622	MODULO DE PROTEINAS DO SORO DO LEITE PO EN GR	0.0000	6.6000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	51434	BECLOMETASONA 400 MCG / ML 2 ML SL IN FL	0.0000	4.4800	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	51434	BECLOMETASONA 400 MCG / ML 2 ML SL IN FL	0.0000	4.4800	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	51379	SERINGA DESC 05 ML UN	0.0000	0.1900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	51379	SERINGA DESC 05 ML UN	0.0000	0.1900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	51379	SERINGA DESC 05 ML UN	0.0000	0.1900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	51379	SERINGA DESC 05 ML UN	0.0000	0.1900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	51164	AGUA BIDESTILADA 500 ML	0.0000	6.4300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	51163	AGUA BIDESTILADA 250 ML	0.0000	5.7900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.0000	0.4000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.0000	0.4000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.0000	0.0000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.0000	0.4000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.0000	0.4000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.0000	0.4000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.0000	0.0000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.0000	1.3700	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	526685c1041cc1316e874a2e95e67e2e	JOSE	12696604949	NULL	12696604949	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1760	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12558131243	NULL	12558131243	00919	ALGODAO HIDROFILO BOLINHA UN	0.0000	0.1000	NULL	VALOR APRESENTADO A MAIOR	1705
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12558131243	NULL	12558131243	52010511	Fratura do Cóccix - Tratamento Cruento	0.0000	0.0000	NULL	COBRANCA DE HONORARIOS EM DUPLICIDADE	2607
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12558131243	NULL	12558131243	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1757	NULL	VALOR APRESENTADO A MAIOR	1705
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12558131243	NULL	12558131243	00501	DRAMIN B6 DL (DIMENIDRINATO + PIRIDOXINA + GLIC.	0.0000	2.2100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12558131243	NULL	12558131243	35382	COMPRESSAS DE GASES 7.5 X7,5 (11 FIOS ESTERIL) UN	0.0000	0.0000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12558131243	NULL	12558131243	25040014	Fisioterapia Respiratória - em Doente Clínico Internado	0.0000	12.2800	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	752c651cb4fd049e19c685f87fbe8bdc	EDUARDO	12765990646	NULL	12765990646	00069	SERINGA DESC 10 ML UN	0.0000	0.6650	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	752c651cb4fd049e19c685f87fbe8bdc	EDUARDO	12765990646	NULL	12765990646	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.0000	0.6875	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	752c651cb4fd049e19c685f87fbe8bdc	EDUARDO	12765990646	NULL	12765990646	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.0000	0.6875	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	800720d33fe0defb6121e82dd216d044	JALMO	12786952647	NULL	12786952647	00090	SERINGA DESC 20 ML UN	0.0000	0.5400	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	800720d33fe0defb6121e82dd216d044	JALMO	12786952647	NULL	12786952647	00090	SERINGA DESC 20 ML UN	0.0000	0.5400	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	800720d33fe0defb6121e82dd216d044	JALMO	12786952647	NULL	12786952647	00757	CEFUROXIMA 750 MG + DIL. 6 ML PO IM IV FA	0.0000	26.1300	NULL	VALOR APRESENTADO A MAIOR	1705
Glosa Min	2018-10-03 00:00:00.000000	1084117	800720d33fe0defb6121e82dd216d044	JALMO	12786952647	NULL	12786952647	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	56261	CLOREXIDINA 2 % ST TP ML DEGERMANTE	NULL	0.0000	NULL	OPME INVALIDO	2201
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1d6bbb4a00130e2e654e830fc9bae6a	ALEXANDRINA	12694224940	NULL	12694224940	05274	AMOXICILINA 500 MG + CLAVULANATO 125 MG CP	3.1700	3.1667	0.0033	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1d6bbb4a00130e2e654e830fc9bae6a	ALEXANDRINA	12694224940	NULL	12694224940	05274	AMOXICILINA 500 MG + CLAVULANATO 125 MG CP	3.1700	3.1667	0.0033	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1d6bbb4a00130e2e654e830fc9bae6a	ALEXANDRINA	12694224940	NULL	12694224940	05274	AMOXICILINA 500 MG + CLAVULANATO 125 MG CP	3.1700	3.1667	0.0033	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	08664	ESPARADRAPO MICROPORE 50 X 10 CM CM	1.3564	1.3849	-0.8749	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	08664	ESPARADRAPO MICROPORE 50 X 10 CM CM	1.3564	1.3849	-0.8749	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	55018	ALGINATO DE CALCIO EM HIDROGEL GL TP GR	3.4500	3.4500	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	28959	DERSANI LC TP ML	12.6100	13.5800	-3.8800	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	05975	COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER	1.3439	1.3948	-0.7948	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	05975	COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER	1.3439	1.3948	-0.7948	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	27600	ONDANSETRONA 2 MG/ML 4 ML SI IM IV AP	81.1800	94.7100	-81.1800	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	09636	FLORATIL (SACCHAROMYCES BOULARDII) 200 MG P	4.4400	8.8851	-4.4451	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	09636	FLORATIL (SACCHAROMYCES BOULARDII) 200 MG P	4.4400	8.8851	-4.4451	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	09636	FLORATIL (SACCHAROMYCES BOULARDII) 200 MG P	4.4400	8.8851	-4.4451	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	33219	LUVA DE PROCEDIMENTO UNIDADE UN	0.3300	0.3350	-0.0050	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00426	AGUA BIDESTILADA 10 ML SI IV IM AP	0.4000	0.4037	-0.0037	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00426	AGUA BIDESTILADA 10 ML SI IV IM AP	0.4000	0.4037	-0.0037	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	19160	SERINGA DESC 20 ML UN	0.5400	0.5374	0.0026	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	19160	SERINGA DESC 20 ML UN	0.5400	0.5374	0.0026	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	19160	SERINGA DESC 20 ML UN	0.5400	0.5374	0.0026	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	19160	SERINGA DESC 20 ML UN	0.5400	0.5374	0.0026	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	19160	SERINGA DESC 20 ML UN	0.5400	0.5374	0.0026	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.2120	-0.1120	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.2120	-0.1120	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.2120	-0.1120	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.2120	-0.1120	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.2120	-0.1120	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	33227	LUVA CIRURGICA PAR UN	2.9000	2.9000	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	33227	LUVA CIRURGICA PAR UN	2.9000	2.9000	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	33227	LUVA CIRURGICA PAR UN	2.9000	2.9000	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	33227	LUVA CIRURGICA PAR UN	2.9000	2.9000	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	33227	LUVA CIRURGICA PAR UN	2.9000	4.3500	-1.4500	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4072	0.0028	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4072	0.0028	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	6.8145	-3.4045	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	6.8145	-3.4045	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	6.8145	-3.4045	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	6.8145	-3.4045	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	6.8145	-3.4045	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	6.8145	-3.4045	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	33545	PIPERACILINA 4 G + TAZOBACTAM 500 MG PO IV	83.4500	83.4500	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	08664	ESPARADRAPO MICROPORE 50 X 10 CM CM	0.2600	0.0000	0.2600	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1770	0.0030	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1770	0.0030	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1770	0.0030	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12647284040	NULL	12647284040	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4086	0.0014	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12647284040	NULL	12647284040	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4086	0.0014	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12647284040	NULL	12647284040	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4086	0.0014	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12647284040	NULL	12647284040	20567	SORO FISIOLOGICO 0,9% 500 ML SI IV BS	9.4700	9.4697	0.0003	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12647284040	NULL	12647284040	08664	ESPARADRAPO MICROPORE 50 X 10 CM CM	0.7700	0.7667	0.0033	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12647284040	NULL	12647284040	00035	ABOCATH (CATETER INTRAVENOSO) N. 14 A 22 UN	3.7700	3.7600	0.0000	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	610c198ec4c064687cf0524f147d3aed	ROBERTO	12748814743	NULL	12748814743	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4083	0.0017	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	610c198ec4c064687cf0524f147d3aed	ROBERTO	12748814743	NULL	12748814743	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4083	0.0017	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	610c198ec4c064687cf0524f147d3aed	ROBERTO	12748814743	NULL	12748814743	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1767	0.0033	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	610c198ec4c064687cf0524f147d3aed	ROBERTO	12748814743	NULL	12748814743	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1767	0.0033	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	610c198ec4c064687cf0524f147d3aed	ROBERTO	12748814743	NULL	12748814743	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1767	0.0033	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	75bcd473a0dc7c7a6751499b38a4a034	JOAQUIM	12692852143	NULL	12692852143	37761	ALCOOL ETILICO 70 % ST TP ML	0.0300	0.0000	0.0300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	75bcd473a0dc7c7a6751499b38a4a034	JOAQUIM	12692852143	NULL	12692852143	00817	ALGODAO HIDROFILO BOLINHA UN	0.1000	0.0000	0.1000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00426	AGUA BIDESTILADA 10 ML SI IV IM AP	0.8100	0.8079	0.0021	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	29661	NOREPINEFRINA 2 MG/ML 4 ML SI IV AP	75.9700	75.9700	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	29661	NOREPINEFRINA 2 MG/ML 4 ML SI IV AP	75.9700	75.9700	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	0111beed375944f60c7ad4a7fd4874f8	WALDIR	12746025744	NULL	12746025744	00426	AGUA BIDESTILADA 10 ML SI IV IM AP	0.8100	0.8077	0.0023	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	0111beed375944f60c7ad4a7fd4874f8	WALDIR	12746025744	NULL	12746025744	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1773	0.0027	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	0111beed375944f60c7ad4a7fd4874f8	WALDIR	12746025744	NULL	12746025744	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1773	0.0027	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	0111beed375944f60c7ad4a7fd4874f8	WALDIR	12746025744	NULL	12746025744	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1773	0.0027	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	6799aa3de305405ab065aad5b599765c	VANIR	12700232345	NULL	12700232345	07269	DIPIRONA 500 MG/ML 2 ML SI IV IM AP	0.6900	0.6870	0.0030	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	6799aa3de305405ab065aad5b599765c	VANIR	12700232345	NULL	12700232345	07269	DIPIRONA 500 MG/ML 2 ML SI IV IM AP	0.6900	0.6870	0.0030	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	6799aa3de305405ab065aad5b599765c	VANIR	12700232345	NULL	12700232345	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1750	0.0050	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	11193	CLOREXIDINA 2 % ST TP ML	0.5300	0.5300	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	00426	AGUA BIDESTILADA 10 ML SI IV IM AP	0.8100	0.8092	0.0008	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	00426	AGUA BIDESTILADA 10 ML SI IV IM AP	0.8100	0.8092	0.0008	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	00426	AGUA BIDESTILADA 10 ML SI IV IM AP	0.8100	0.8092	0.0008	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	00426	AGUA BIDESTILADA 10 ML SI IV IM AP	0.8100	0.8092	0.0008	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	00426	AGUA BIDESTILADA 10 ML SI IV IM AP	0.8100	0.8092	0.0008	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	53660	EQUIPO MACRO-GOTAS FLEXIVEL C/ INJETOR LATE	1.5900	1.5900	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1776	0.0024	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1776	0.0024	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1776	0.0024	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1776	0.0024	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1776	0.0024	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1776	0.0024	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1776	0.0024	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	19160	SERINGA DESC 20 ML UN	0.5400	0.5384	0.0016	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	19160	SERINGA DESC 20 ML UN	0.5400	0.5384	0.0016	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	19160	SERINGA DESC 20 ML UN	0.5400	0.5384	0.0016	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	19160	SERINGA DESC 20 ML UN	0.5400	0.5384	0.0016	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	19160	SERINGA DESC 20 ML UN	0.5400	0.5384	0.0016	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	19151	SERINGA DESC 10 ML UN	0.3300	0.3333	-0.0033	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	19151	SERINGA DESC 10 ML UN	0.3300	0.3333	-0.0033	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	33227	LUVA CIRURGICA PAR UN	1.4500	1.4476	0.0024	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	33227	LUVA CIRURGICA PAR UN	1.4500	1.4476	0.0024	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	33227	LUVA CIRURGICA PAR UN	1.4500	1.4476	0.0024	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	33227	LUVA CIRURGICA PAR UN	1.4500	1.4476	0.0024	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00426	AGUA BIDESTILADA 10 ML SI IV IM AP	1.6200	0.0000	1.6200	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00426	AGUA BIDESTILADA 10 ML SI IV IM AP	1.2100	0.0000	1.2100	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.1000	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.1000	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.1000	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.1000	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.1000	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.1000	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.1000	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.1000	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.1000	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	6ccea6ac8c216c032723aee73a9f81c9	PRISCILA	12662249242	NULL	12662249242	19160	SERINGA DESC 20 ML UN	0.5400	0.5373	0.0027	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	6ccea6ac8c216c032723aee73a9f81c9	PRISCILA	12662249242	NULL	12662249242	07269	DIPIRONA 500 MG/ML 2 ML SI IV IM AP	0.6900	0.6864	0.0036	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	6ccea6ac8c216c032723aee73a9f81c9	PRISCILA	12662249242	NULL	12662249242	20672	SORO RINGER SIMPLES 500 ML SI IV BS	5.9400	5.9375	0.0025	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00817	ALGODAO HIDROFILO BOLINHA UN	0.3800	0.1300	0.2500	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	d17b3c5ae418d82694895a326dee545a	ODILIA	12670516743	NULL	12670516743	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1774	0.0026	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	08664	ESPARADRAPO MICROPORE 50 X 10 CM CM	0.7700	0.2550	0.5150	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	19135	SERINGA DESC 03 ML UN	0.1500	0.0000	0.1500	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	53660	EQUIPO MACRO-GOTAS FLEXIVEL C/ INJETOR LATE	1.5900	1.5900	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	e2b254ce765be196b019032789d8f852	MARIA	12576216044	NULL	12576216044	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4078	0.0022	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	08664	ESPARADRAPO MICROPORE 50 X 10 CM CM	0.2600	0.2558	0.0042	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	08664	ESPARADRAPO MICROPORE 50 X 10 CM CM	0.2600	0.2558	0.0042	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	08664	ESPARADRAPO MICROPORE 50 X 10 CM CM	0.2600	0.2558	0.0042	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	11193	CLOREXIDINA 2 % ST TP ML	0.5300	0.5320	-0.0020	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1900	0.1779	0.0121	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1779	0.0021	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1779	0.0021	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	19160	SERINGA DESC 20 ML UN	1.0800	1.0744	0.0056	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	19160	SERINGA DESC 20 ML UN	0.5400	0.5372	0.0028	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	19160	SERINGA DESC 20 ML UN	0.5400	0.5372	0.0028	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	19160	SERINGA DESC 20 ML UN	0.5400	0.5372	0.0028	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	19160	SERINGA DESC 20 ML UN	0.5400	0.5372	0.0028	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	19160	SERINGA DESC 20 ML UN	0.5400	0.5372	0.0028	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00426	AGUA BIDESTILADA 10 ML SI IV IM AP	0.8100	0.8073	0.0027	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1769	0.0031	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1769	0.0031	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1769	0.0031	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	19160	SERINGA DESC 20 ML UN	0.5400	0.5375	0.0025	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	19160	SERINGA DESC 20 ML UN	0.5400	0.5375	0.0025	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	19160	SERINGA DESC 20 ML UN	0.5400	0.5375	0.0025	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	07269	DIPIRONA 500 MG/ML 2 ML SI IV IM AP	0.6900	0.6865	0.0035	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	07269	DIPIRONA 500 MG/ML 2 ML SI IV IM AP	0.6900	0.6865	0.0035	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	07269	DIPIRONA 500 MG/ML 2 ML SI IV IM AP	0.6900	0.6865	0.0035	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	07269	DIPIRONA 500 MG/ML 2 ML SI IV IM AP	0.6900	0.6865	0.0035	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4075	0.0025	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4075	0.0025	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4075	0.0025	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4075	0.0025	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	19445	CLORETO DE POTASSIO 600 MG CA VO UN	0.4900	0.4867	0.0033	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	32204	CLORETO DE SODIO 0,9% 10 ML SI IV AP	0.9600	0.9600	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	20cbe2e07b1dcd2b6af609a50df7ae80	LUCELENA	12690767849	NULL	12690767849	19160	SERINGA DESC 20 ML UN	0.5400	0.5384	0.0016	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	20cbe2e07b1dcd2b6af609a50df7ae80	LUCELENA	12690767849	NULL	12690767849	19160	SERINGA DESC 20 ML UN	0.5400	0.5384	0.0016	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	20cbe2e07b1dcd2b6af609a50df7ae80	LUCELENA	12690767849	NULL	12690767849	19160	SERINGA DESC 20 ML UN	0.5400	0.5384	0.0016	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	20cbe2e07b1dcd2b6af609a50df7ae80	LUCELENA	12690767849	NULL	12690767849	19160	SERINGA DESC 20 ML UN	0.5400	0.5384	0.0016	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	20cbe2e07b1dcd2b6af609a50df7ae80	LUCELENA	12690767849	NULL	12690767849	19160	SERINGA DESC 20 ML UN	0.5400	0.5384	0.0016	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	20cbe2e07b1dcd2b6af609a50df7ae80	LUCELENA	12690767849	NULL	12690767849	19160	SERINGA DESC 20 ML UN	0.5400	0.5384	0.0016	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	20cbe2e07b1dcd2b6af609a50df7ae80	LUCELENA	12690767849	NULL	12690767849	19160	SERINGA DESC 20 ML UN	0.5400	0.5384	0.0016	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	20cbe2e07b1dcd2b6af609a50df7ae80	LUCELENA	12690767849	NULL	12690767849	19160	SERINGA DESC 20 ML UN	0.5400	0.5384	0.0016	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	20cbe2e07b1dcd2b6af609a50df7ae80	LUCELENA	12690767849	NULL	12690767849	19160	SERINGA DESC 20 ML UN	0.5400	0.5384	0.0016	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	20cbe2e07b1dcd2b6af609a50df7ae80	LUCELENA	12690767849	NULL	12690767849	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4084	0.0016	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	20cbe2e07b1dcd2b6af609a50df7ae80	LUCELENA	12690767849	NULL	12690767849	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4084	0.0016	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	20cbe2e07b1dcd2b6af609a50df7ae80	LUCELENA	12690767849	NULL	12690767849	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4084	0.0016	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	20cbe2e07b1dcd2b6af609a50df7ae80	LUCELENA	12690767849	NULL	12690767849	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4084	0.0016	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	20cbe2e07b1dcd2b6af609a50df7ae80	LUCELENA	12690767849	NULL	12690767849	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1758	0.0042	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	20cbe2e07b1dcd2b6af609a50df7ae80	LUCELENA	12690767849	NULL	12690767849	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1758	0.0042	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	20cbe2e07b1dcd2b6af609a50df7ae80	LUCELENA	12690767849	NULL	12690767849	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1758	0.0042	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	20cbe2e07b1dcd2b6af609a50df7ae80	LUCELENA	12690767849	NULL	12690767849	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1758	0.0042	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	20cbe2e07b1dcd2b6af609a50df7ae80	LUCELENA	12690767849	NULL	12690767849	07269	DIPIRONA 500 MG/ML 2 ML SI IV IM AP	0.6900	0.6850	0.0050	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	20cbe2e07b1dcd2b6af609a50df7ae80	LUCELENA	12690767849	NULL	12690767849	27480	CLARITROMICINA 500 MG 30 ML PO IV FA	117.1100	117.1050	0.0050	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	20cbe2e07b1dcd2b6af609a50df7ae80	LUCELENA	12690767849	NULL	12690767849	27480	CLARITROMICINA 500 MG 30 ML PO IV FA	117.1100	117.1050	0.0050	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	20cbe2e07b1dcd2b6af609a50df7ae80	LUCELENA	12690767849	NULL	12690767849	00817	ALGODAO HIDROFILO BOLINHA UN	0.1300	0.0000	0.1300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	670141098c0309ac9be3db204bdc12cf	LEOSINA	12706525442	NULL	12706525442	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1765	0.0035	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	b288bbcfb9aecab51bcb0dba62ca0059	IVONETE	12743730847	NULL	12743730847	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4067	0.0033	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12550571048	NULL	12550571048	05975	COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER	0.6000	0.1500	0.4500	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12550571048	NULL	12550571048	05975	COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER	0.3000	0.0000	0.3000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12550571048	NULL	12550571048	08648	ESPARADRAPO 10 X 4.5 CM CM	0.4000	0.2000	0.2000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12550571048	NULL	12550571048	05975	COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER	0.3000	0.0000	0.3000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12550571048	NULL	12550571048	05975	COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER	0.3000	0.0000	0.3000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	20567	SORO FISIOLOGICO 0,9% 500 ML SI IV BS	4.7300	4.7350	-0.0050	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	08435	EQUIPO P/ BOMBA DE INFUSAO ENTERAL / PARENT	20.2800	20.2780	0.0020	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	08435	EQUIPO P/ BOMBA DE INFUSAO ENTERAL / PARENT	20.2800	20.2780	0.0020	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	08435	EQUIPO P/ BOMBA DE INFUSAO ENTERAL / PARENT	20.2800	20.2780	0.0020	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	00426	AGUA BIDESTILADA 10 ML SI IV IM AP	0.8100	0.8091	0.0009	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	00426	AGUA BIDESTILADA 10 ML SI IV IM AP	0.4000	0.4045	-0.0045	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	00426	AGUA BIDESTILADA 10 ML SI IV IM AP	0.4000	0.4049	-0.0049	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1900	0.1797	0.0103	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1797	0.0003	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1797	0.0003	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	19160	SERINGA DESC 20 ML UN	0.5400	0.5378	0.0022	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.1038	-0.0038	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.1038	-0.0038	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.1038	-0.0038	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	345c226bfea274af1372d41b0305a6c8	ALTINO	12720257940	NULL	12720257940	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.1000	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	345c226bfea274af1372d41b0305a6c8	ALTINO	12720257940	NULL	12720257940	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.1000	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1d6bbb4a00130e2e654e830fc9bae6a	ALEXANDRINA	12694224940	NULL	12694224940	19160	SERINGA DESC 20 ML UN	0.5400	0.5367	0.0033	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1d6bbb4a00130e2e654e830fc9bae6a	ALEXANDRINA	12694224940	NULL	12694224940	00035	ABOCATH (CATETER INTRAVENOSO) N. 14 A 22 UN	11.3000	11.2900	0.0000	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	eecb3d883747b059c3fe231c34567476	AFFRIDES	12693180144	NULL	12693180144	19160	SERINGA DESC 20 ML UN	0.5400	0.5372	0.0028	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	eecb3d883747b059c3fe231c34567476	AFFRIDES	12693180144	NULL	12693180144	19160	SERINGA DESC 20 ML UN	0.5400	0.5372	0.0028	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	eecb3d883747b059c3fe231c34567476	AFFRIDES	12693180144	NULL	12693180144	19160	SERINGA DESC 20 ML UN	0.5400	0.5372	0.0028	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	eecb3d883747b059c3fe231c34567476	AFFRIDES	12693180144	NULL	12693180144	19160	SERINGA DESC 20 ML UN	0.5400	0.5372	0.0028	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	eecb3d883747b059c3fe231c34567476	AFFRIDES	12693180144	NULL	12693180144	19160	SERINGA DESC 20 ML UN	0.5400	0.5372	0.0028	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	eecb3d883747b059c3fe231c34567476	AFFRIDES	12693180144	NULL	12693180144	19160	SERINGA DESC 20 ML UN	0.5400	0.5372	0.0028	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	eecb3d883747b059c3fe231c34567476	AFFRIDES	12693180144	NULL	12693180144	19160	SERINGA DESC 20 ML UN	0.5400	0.5372	0.0028	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	eecb3d883747b059c3fe231c34567476	AFFRIDES	12693180144	NULL	12693180144	19160	SERINGA DESC 20 ML UN	0.5400	0.5372	0.0028	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	eecb3d883747b059c3fe231c34567476	AFFRIDES	12693180144	NULL	12693180144	19160	SERINGA DESC 20 ML UN	0.5400	0.5372	0.0028	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	eecb3d883747b059c3fe231c34567476	AFFRIDES	12693180144	NULL	12693180144	19160	SERINGA DESC 20 ML UN	0.5400	0.5372	0.0028	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	eecb3d883747b059c3fe231c34567476	AFFRIDES	12693180144	NULL	12693180144	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4074	0.0026	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	eecb3d883747b059c3fe231c34567476	AFFRIDES	12693180144	NULL	12693180144	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4074	0.0026	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	d4089ccef13567fd45b16fb0b60685fa	VERA	12640482546	NULL	12640482546	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1754	0.0046	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	d4089ccef13567fd45b16fb0b60685fa	VERA	12640482546	NULL	12640482546	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1754	0.0046	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	d4089ccef13567fd45b16fb0b60685fa	VERA	12640482546	NULL	12640482546	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1754	0.0046	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	d4089ccef13567fd45b16fb0b60685fa	VERA	12640482546	NULL	12640482546	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1754	0.0046	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	d4089ccef13567fd45b16fb0b60685fa	VERA	12640482546	NULL	12640482546	27480	CLARITROMICINA 500 MG 30 ML PO IV FA	117.1100	117.1050	0.0050	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	d4089ccef13567fd45b16fb0b60685fa	VERA	12640482546	NULL	12640482546	27480	CLARITROMICINA 500 MG 30 ML PO IV FA	117.1100	117.1050	0.0050	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	d4089ccef13567fd45b16fb0b60685fa	VERA	12640482546	NULL	12640482546	27480	CLARITROMICINA 500 MG 30 ML PO IV FA	117.1100	117.1050	0.0050	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	d4089ccef13567fd45b16fb0b60685fa	VERA	12640482546	NULL	12640482546	27480	CLARITROMICINA 500 MG 30 ML PO IV FA	117.1100	117.1050	0.0050	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	f93cee6f501560245a8f94ffc5c6c246	ROSEDALIA	12622895145	NULL	12622895145	19160	SERINGA DESC 20 ML UN	0.5400	0.5373	0.0027	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	c2bcdc3cbedb73a0db271ac09d4587a1	ORDETE	12694018147	NULL	12694018147	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1760	0.0040	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	c2bcdc3cbedb73a0db271ac09d4587a1	ORDETE	12694018147	NULL	12694018147	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1760	0.0040	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	f65f553befc0e3bc8bd5bce5c1c6e413	NAIRLENE	12633078944	NULL	12633078944	07269	DIPIRONA 500 MG/ML 2 ML SI IV IM AP	0.6900	0.6867	0.0033	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	f65f553befc0e3bc8bd5bce5c1c6e413	NAIRLENE	12633078944	NULL	12633078944	07269	DIPIRONA 500 MG/ML 2 ML SI IV IM AP	0.6900	0.6867	0.0033	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	f65f553befc0e3bc8bd5bce5c1c6e413	NAIRLENE	12633078944	NULL	12633078944	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1760	0.0040	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	f65f553befc0e3bc8bd5bce5c1c6e413	NAIRLENE	12633078944	NULL	12633078944	33219	LUVA DE PROCEDIMENTO UNIDADE UN	1.6700	1.6650	0.0050	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	7c2bc8cd9bbf9ce081562a3c63fff8c9	MARTA	12647505849	NULL	12647505849	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1756	0.0044	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	7c2bc8cd9bbf9ce081562a3c63fff8c9	MARTA	12647505849	NULL	12647505849	22896	CEFUROXIMA 750 MG + DIL. 6 ML PO IM IV FA	26.1300	26.1250	0.0050	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	37761	ALCOOL ETILICO 70 % ST TP ML	0.0300	0.0200	0.0100	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	37761	ALCOOL ETILICO 70 % ST TP ML	0.0300	0.0200	0.0100	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	37761	ALCOOL ETILICO 70 % ST TP ML	0.0300	0.0200	0.0100	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	32891	EQUIPO POLIFIX 2ş VIAS UN	2.5500	0.0000	2.5500	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00817	ALGODAO HIDROFILO BOLINHA UN	0.2600	0.1300	0.1300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12558131243	NULL	12558131243	08664	ESPARADRAPO MICROPORE 50 X 10 CM CM	0.7700	0.2600	0.5100	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12558131243	NULL	12558131243	11193	CLOREXIDINA 2 % ST TP ML	0.5300	0.2700	0.2600	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12558131243	NULL	12558131243	11193	CLOREXIDINA 2 % ST TP ML	0.5300	0.2700	0.2600	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12558131243	NULL	12558131243	11193	CLOREXIDINA 2 % ST TP ML	0.5300	0.2700	0.2600	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12558131243	NULL	12558131243	08664	ESPARADRAPO MICROPORE 50 X 10 CM CM	0.7700	0.2600	0.5100	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1965b0cdebe9017c3397c8641147759	JOSE	12705413746	NULL	12705413746	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1900	0.0000	0.1900	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1965b0cdebe9017c3397c8641147759	JOSE	12705413746	NULL	12705413746	18457	REPARIL (ESCINA + DIETILAMONIO) GL TP GR	3.7500	0.0000	3.7500	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	55018	ALGINATO DE CALCIO EM HIDROGEL GL TP GR	6.9000	3.4500	3.4500	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	37761	ALCOOL ETILICO 70 % ST TP ML	0.0300	0.0200	0.0100	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	37761	ALCOOL ETILICO 70 % ST TP ML	0.0300	0.0200	0.0100	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	28959	DERSANI LC TP ML	19.4000	9.7000	9.7000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	05975	COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER	0.3000	0.0000	0.3000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	33219	LUVA DE PROCEDIMENTO UNIDADE UN	1.0000	0.6700	0.3300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	37761	ALCOOL ETILICO 70 % ST TP ML	0.0300	0.0200	0.0100	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	00817	ALGODAO HIDROFILO BOLINHA UN	0.2600	0.1300	0.1300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	00817	ALGODAO HIDROFILO BOLINHA UN	0.2600	0.1300	0.1300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	20567	SORO FISIOLOGICO 0,9% 500 ML SI IV BS	4.7300	0.0000	4.7300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	11193	CLOREXIDINA 2 % ST TP ML	0.5300	0.0000	0.5300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	4668d2494ed6c4b2d18be299efcb26a2	JOAO	12469689344	NULL	12469689344	08648	ESPARADRAPO 10 X 4.5 CM CM	0.4000	0.2600	0.1400	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	75bcd473a0dc7c7a6751499b38a4a034	JOAQUIM	12692852143	NULL	12692852143	37761	ALCOOL ETILICO 70 % ST TP ML	0.0300	0.0200	0.0100	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	75bcd473a0dc7c7a6751499b38a4a034	JOAQUIM	12692852143	NULL	12692852143	08648	ESPARADRAPO 10 X 4.5 CM CM	0.4000	0.1000	0.3000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	37761	ALCOOL ETILICO 70 % ST TP ML	0.0300	0.0200	0.0100	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	37761	ALCOOL ETILICO 70 % ST TP ML	0.0600	0.0200	0.0400	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	33219	LUVA DE PROCEDIMENTO UNIDADE UN	1.6700	0.6700	1.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12550571048	NULL	12550571048	37761	ALCOOL ETILICO 70 % ST TP ML	0.0600	0.0200	0.0400	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12550571048	NULL	12550571048	33219	LUVA DE PROCEDIMENTO UNIDADE UN	1.6700	0.6700	1.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12550571048	NULL	12550571048	08648	ESPARADRAPO 10 X 4.5 CM CM	0.4000	0.2000	0.2000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12550571048	NULL	12550571048	37761	ALCOOL ETILICO 70 % ST TP ML	0.0600	0.0200	0.0400	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12550571048	NULL	12550571048	33219	LUVA DE PROCEDIMENTO UNIDADE UN	1.0000	0.6700	0.3300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12550571048	NULL	12550571048	33219	LUVA DE PROCEDIMENTO UNIDADE UN	1.0000	0.6700	0.3300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12550571048	NULL	12550571048	08648	ESPARADRAPO 10 X 4.5 CM CM	0.4000	0.2000	0.2000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12550571048	NULL	12550571048	33219	LUVA DE PROCEDIMENTO UNIDADE UN	1.0000	0.6700	0.3300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	b288bbcfb9aecab51bcb0dba62ca0059	IVONETE	12743730847	NULL	12743730847	57495	FILTRO BARREIRA E REGENERADOR DE CALOR E UM	24.0000	0.0000	24.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	dd6f8d6c53ffe9bfd3aa9590ba500cc8	ILDA	12751932542	NULL	12751932542	08664	ESPARADRAPO MICROPORE 50 X 10 CM CM	0.7700	0.0000	0.7700	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	dd6f8d6c53ffe9bfd3aa9590ba500cc8	ILDA	12751932542	NULL	12751932542	08664	ESPARADRAPO MICROPORE 50 X 10 CM CM	1.5400	0.5100	1.0300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	01081195	ea21814027c9a23a6af0dd86f5bd1998	BENEDITA	12751372213	NULL	12751372213	00010014	CONSULTA EM CONSULTORIO MEDICO	0.0000	0.0000	50.0000	GUIA DE CONSULTA NAO EXECUTADA	0622
Glosa Min	2018-10-03 00:00:00.000000	01081195	68c12713747b34e80e50b5a3bd2dc90e	SISSI	12748889510	NULL	12748889510	00010014	CONSULTA EM CONSULTORIO MEDICO	0.0000	0.0000	50.0000	GUIA DE CONSULTA NAO EXECUTADA	0622
Glosa Min	2018-10-03 00:00:00.000000	1084117	345c226bfea274af1372d41b0305a6c8	ALTINO	12720257940	NULL	12720257940	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.1000	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	345c226bfea274af1372d41b0305a6c8	ALTINO	12720257940	NULL	12720257940	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.1000	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	345c226bfea274af1372d41b0305a6c8	ALTINO	12720257940	NULL	12720257940	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.1000	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	345c226bfea274af1372d41b0305a6c8	ALTINO	12720257940	NULL	12720257940	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1750	0.0050	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	345c226bfea274af1372d41b0305a6c8	ALTINO	12720257940	NULL	12720257940	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1750	0.0050	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	345c226bfea274af1372d41b0305a6c8	ALTINO	12720257940	NULL	12720257940	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1750	0.0050	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	345c226bfea274af1372d41b0305a6c8	ALTINO	12720257940	NULL	12720257940	07269	DIPIRONA 500 MG/ML 2 ML SI IV IM AP	0.6900	0.6860	0.0040	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	345c226bfea274af1372d41b0305a6c8	ALTINO	12720257940	NULL	12720257940	13404	OMEPRAZOL 40 MG + DIL. 10 ML PO IV FA	19.5800	19.5750	0.0050	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	0405a686318e3fc262f105ed4be24d95	CARMELITA	12687161644	NULL	12687161644	33227	LUVA CIRURGICA PAR UN	1.4500	1.4400	0.0000	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	0405a686318e3fc262f105ed4be24d95	CARMELITA	12687161644	NULL	12687161644	19160	SERINGA DESC 20 ML UN	0.5400	0.5367	0.0033	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	ea6abb4182a48f0934f3e9eb5affa056	DILVA	12697455440	NULL	12697455440	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1750	0.0050	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	27600	ONDANSETRONA 2 MG/ML 4 ML SI IM IV AP	13.5300	0.0000	13.5300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	27600	ONDANSETRONA 2 MG/ML 4 ML SI IM IV AP	13.5300	0.0000	13.5300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	33219	LUVA DE PROCEDIMENTO UNIDADE UN	0.6700	0.6700	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	27600	ONDANSETRONA 2 MG/ML 4 ML SI IM IV AP	13.5300	0.0000	13.5300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	11193	CLOREXIDINA 2 % ST TP ML	0.8000	0.7972	0.0028	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	27600	ONDANSETRONA 2 MG/ML 4 ML SI IM IV AP	13.5300	0.0000	13.5300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	27600	ONDANSETRONA 2 MG/ML 4 ML SI IM IV AP	13.5300	0.0000	13.5300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	11193	CLOREXIDINA 2 % ST TP ML	0.8000	0.7972	0.0028	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	01496	FENITOINA 50 MG/ML 5 ML SI IM IV AP	0.0000	2.3400	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00128	LUVA DE PROCEDIMENTO UNIDADE UN	0.0000	1.6700	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	35382	COMPRESSAS DE GASES 7.5 X7,5 (11 FIOS ESTERIL) UN	0.0000	0.6000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.0000	0.6874	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.0000	0.6874	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.0000	0.6874	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.0000	0.6874	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.0000	0.6874	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.0000	0.6874	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.0000	0.6874	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.0000	0.6874	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.0000	0.6874	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	52392	SONDA DE ASPIRAÇAO TRAQUEAL C/ VALVULA UN	0.0000	0.9352	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	52392	SONDA DE ASPIRAÇAO TRAQUEAL C/ VALVULA UN	0.0000	0.9352	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	52392	SONDA DE ASPIRAÇAO TRAQUEAL C/ VALVULA UN	0.0000	0.9352	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	51649	ALCOOL ETILICO 70 % ST TP ML	0.0000	0.0000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	51590	ABAIXADOR DE LINGUA UN	0.0000	0.0500	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	51241	AGULHA 123X45	0.0000	0.1900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	51241	AGULHA 123X45	0.0000	0.1900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	51241	AGULHA 123X45	0.0000	0.1900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	51241	AGULHA 123X45	0.0000	0.1900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	51241	AGULHA 123X45	0.0000	0.1900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	51241	AGULHA 123X45	0.0000	0.1900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	51241	AGULHA 123X45	0.0000	0.1900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1800	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1752	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1752	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1752	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1752	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1752	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.0000	0.4000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.0000	0.4000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	35382	COMPRESSAS DE GASES 7.5 X7,5 (11 FIOS ESTERIL) UN	0.0000	0.0900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4094	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	00128	LUVA DE PROCEDIMENTO UNIDADE UN	0.0000	1.6700	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	00124	LUVA CIRURGICA UN	0.0000	1.4482	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	00124	LUVA CIRURGICA UN	0.0000	1.4482	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	00124	LUVA CIRURGICA UN	0.0000	1.4482	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	00124	LUVA CIRURGICA UN	0.0000	1.4500	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	00124	LUVA CIRURGICA UN	0.0000	1.4482	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	00124	LUVA CIRURGICA UN	0.0000	1.4500	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	00124	LUVA CIRURGICA UN	0.0000	1.4500	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12579183644	NULL	12579183644	51584	ESPARADRAPO MICROPORE	0.0000	0.2600	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12579183644	NULL	12579183644	51584	ESPARADRAPO MICROPORE	0.0000	0.2600	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12579183644	NULL	12579183644	35382	COMPRESSAS DE GASES 7.5 X7,5 (11 FIOS ESTERIL) UN	0.0000	0.3000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12579183644	NULL	12579183644	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12579183644	NULL	12579183644	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12579183644	NULL	12579183644	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12579183644	NULL	12579183644	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12579183644	NULL	12579183644	25040014	Fisioterapia Respiratória - em Doente Clínico Internado	0.0000	10.0600	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12579183644	NULL	12579183644	00124	LUVA CIRURGICA UN	0.0000	1.4476	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	9ffbbf7340bbd65e9e3baa9406d027f3	MARCO	12261811645	NULL	12261811645	00090	SERINGA DESC 20 ML UN	0.0000	0.5376	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	9ffbbf7340bbd65e9e3baa9406d027f3	MARCO	12261811645	NULL	12261811645	00090	SERINGA DESC 20 ML UN	0.0000	0.5376	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	9ffbbf7340bbd65e9e3baa9406d027f3	MARCO	12261811645	NULL	12261811645	00090	SERINGA DESC 20 ML UN	0.0000	0.5376	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	9ffbbf7340bbd65e9e3baa9406d027f3	MARCO	12261811645	NULL	12261811645	00090	SERINGA DESC 20 ML UN	0.0000	0.5376	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	9ffbbf7340bbd65e9e3baa9406d027f3	MARCO	12261811645	NULL	12261811645	00090	SERINGA DESC 20 ML UN	0.0000	0.5376	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12550571048	NULL	12550571048	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1775	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12550571048	NULL	12550571048	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1775	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12550571048	NULL	12550571048	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1775	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12550571048	NULL	12550571048	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1775	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12550571048	NULL	12550571048	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1775	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12550571048	NULL	12550571048	25040014	Fisioterapia Respiratória - em Doente Clínico Internado	0.0000	10.0600	NULL	EXAME NAO AUTORIZADO	2707
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12550571048	NULL	12550571048	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4074	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12550571048	NULL	12550571048	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4074	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12550571048	NULL	12550571048	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4074	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12550571048	NULL	12550571048	00124	LUVA CIRURGICA UN	0.0000	1.4500	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12550571048	NULL	12550571048	00124	LUVA CIRURGICA UN	0.0000	1.4473	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00090	SERINGA DESC 20 ML UN	0.0000	0.5387	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00090	SERINGA DESC 20 ML UN	0.0000	0.5387	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00090	SERINGA DESC 20 ML UN	0.0000	0.5387	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00090	SERINGA DESC 20 ML UN	0.0000	0.5387	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00090	SERINGA DESC 20 ML UN	0.0000	0.5387	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00090	SERINGA DESC 20 ML UN	0.0000	0.5387	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00090	SERINGA DESC 20 ML UN	0.0000	0.5387	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00090	SERINGA DESC 20 ML UN	0.0000	0.5387	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00090	SERINGA DESC 20 ML UN	0.0000	0.5387	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00090	SERINGA DESC 20 ML UN	0.0000	0.5387	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00090	SERINGA DESC 20 ML UN	0.0000	0.5387	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00090	SERINGA DESC 20 ML UN	0.0000	0.5387	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00090	SERINGA DESC 20 ML UN	0.0000	0.5387	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00090	SERINGA DESC 20 ML UN	0.0000	0.5387	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00090	SERINGA DESC 20 ML UN	0.0000	0.5387	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00090	SERINGA DESC 20 ML UN	0.0000	0.5400	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1766	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1766	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4088	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4088	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4088	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4088	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00943	EQUIPO POLIFIX 2 VIAS UN	0.0000	2.5500	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00090	SERINGA DESC 20 ML UN	0.0000	0.5371	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00090	SERINGA DESC 20 ML UN	0.0000	0.5400	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00090	SERINGA DESC 20 ML UN	0.0000	0.5371	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00090	SERINGA DESC 20 ML UN	0.0000	0.5371	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00090	SERINGA DESC 20 ML UN	0.0000	0.5371	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00090	SERINGA DESC 20 ML UN	0.0000	0.5400	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00090	SERINGA DESC 20 ML UN	0.0000	0.5371	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00090	SERINGA DESC 20 ML UN	0.0000	0.5371	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00090	SERINGA DESC 20 ML UN	0.0000	0.5371	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00090	SERINGA DESC 20 ML UN	0.0000	0.5371	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00090	SERINGA DESC 20 ML UN	0.0000	0.5371	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00090	SERINGA DESC 20 ML UN	0.0000	0.5371	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00090	SERINGA DESC 20 ML UN	0.0000	0.5371	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00090	SERINGA DESC 20 ML UN	0.0000	0.5371	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00090	SERINGA DESC 20 ML UN	0.0000	0.5371	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00090	SERINGA DESC 20 ML UN	0.0000	0.5371	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00090	SERINGA DESC 20 ML UN	0.0000	0.5371	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	24082	BROMOPRIDA 5 MG/ML 2 ML SI IM IV AP	0.0000	2.7300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	24082	BROMOPRIDA 5 MG/ML 2 ML SI IM IV AP	0.0000	2.7300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00170	SORO GLICOSADO 5% 250 ML SI IV BS	0.0000	3.4000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	01584	NEOSTIGMINA 0,5 MG/ML 1 ML SI IM IV SC AP	0.0000	0.7667	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	01584	NEOSTIGMINA 0,5 MG/ML 1 ML SI IM IV SC AP	0.0000	0.7667	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	01584	NEOSTIGMINA 0,5 MG/ML 1 ML SI IM IV SC AP	0.0000	0.7667	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	01584	NEOSTIGMINA 0,5 MG/ML 1 ML SI IM IV SC AP	0.0000	0.7667	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	01584	NEOSTIGMINA 0,5 MG/ML 1 ML SI IM IV SC AP	0.0000	0.7667	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4062	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4062	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4062	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4062	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4062	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4062	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00124	LUVA CIRURGICA UN	0.0000	1.4475	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00919	ALGODAO HIDROFILO BOLINHA UN	0.0000	0.0000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00090	SERINGA DESC 20 ML UN	0.0000	0.0000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	09071	ACETILCISTEINA 600MG PO VO SA	0.0000	3.4950	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	09071	ACETILCISTEINA 600MG PO VO SA	0.0000	3.4950	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	09071	ACETILCISTEINA 600MG PO VO SA	0.0000	3.4950	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	08829	Bricanyl 0,5mg Inj. Ampola C/ 1ml	0.0000	7.1800	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	08829	Bricanyl 0,5mg Inj. Ampola C/ 1ml	0.0000	3.5900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	08829	Bricanyl 0,5mg Inj. Ampola C/ 1ml	0.0000	3.5900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	07802	PIPERACILINA 4 G + TAZOBACTAM 500 MG PO IV FA	0.0000	83.4500	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	07802	PIPERACILINA 4 G + TAZOBACTAM 500 MG PO IV FA	0.0000	83.4500	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00735	CEFTRIAXONA IV 1G + DIL. 10 ML PO IV FA	0.0000	54.1300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00735	CEFTRIAXONA IV 1G + DIL. 10 ML PO IV FA	0.0000	54.1300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00735	CEFTRIAXONA IV 1G + DIL. 10 ML PO IV FA	0.0000	27.0600	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00069	SERINGA DESC 10 ML UN	0.0000	0.0000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00613	CLINDAMICINA 600 MG 4 ML SI IM IV AP	0.0000	13.0800	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00613	CLINDAMICINA 600 MG 4 ML SI IM IV AP	0.0000	13.0800	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	26981	SORO FISIOLOGICO 0,9% 10 ML SI IV AP	0.0000	0.9600	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	02246	HIDROCORTISONA 100 MG PO IM IV FA	0.0000	5.6700	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	02246	HIDROCORTISONA 100 MG PO IM IV FA	0.0000	5.6700	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	02246	HIDROCORTISONA 100 MG PO IM IV FA	0.0000	2.8300	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	02246	HIDROCORTISONA 100 MG PO IM IV FA	0.0000	2.8300	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	02246	HIDROCORTISONA 100 MG PO IM IV FA	0.0000	0.0000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00172	SORO FISIOLOGICO 0,9% 500 ML SI IV BS	0.0000	4.7300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4075	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	01230	FLEET ENEMA (FOSFATO DE SODIO DIBASICO + FOSFATO FR	0.0000	10.2500	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	11700	EQUIPO P/ BOMBA DE INFUSAO ENTERAL / PARENTERAL	0.0000	20.2800	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	11700	EQUIPO P/ BOMBA DE INFUSAO ENTERAL / PARENTERAL	0.0000	20.2800	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	800720d33fe0defb6121e82dd216d044	JALMO	12786952647	NULL	12786952647	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	800720d33fe0defb6121e82dd216d044	JALMO	12786952647	NULL	12786952647	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	05975	COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER	0.7739	0.8051	-0.7751	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	11193	CLOREXIDINA 2 % ST TP ML	0.5300	0.5320	-0.0020	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	11193	CLOREXIDINA 2 % ST TP ML	0.5300	0.5320	-0.0020	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	07269	DIPIRONA 500 MG/ML 2 ML SI IV IM AP	0.6900	0.6860	0.0040	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	13935	METAMUCIL (PLANTAGO OVATA) 5,85 G PO VO E	4.9236	7.3907	-4.9307	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	19151	SERINGA DESC 10 ML UN	0.3300	0.6669	-0.3369	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	19151	SERINGA DESC 10 ML UN	0.3300	0.6669	-0.3369	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	19151	SERINGA DESC 10 ML UN	0.3300	0.6669	-0.3369	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	19151	SERINGA DESC 10 ML UN	0.3300	0.6669	-0.3369	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	19151	SERINGA DESC 10 ML UN	0.3300	0.6669	-0.3369	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	19151	SERINGA DESC 10 ML UN	0.3300	0.6669	-0.3369	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	19151	SERINGA DESC 10 ML UN	0.3300	0.6669	-0.3369	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	19151	SERINGA DESC 10 ML UN	0.3300	0.6669	-0.3369	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	19151	SERINGA DESC 10 ML UN	0.3300	0.6669	-0.3369	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	19151	SERINGA DESC 10 ML UN	0.6634	1.0003	-0.6703	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	19151	SERINGA DESC 10 ML UN	0.6634	1.0003	-0.6703	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	19151	SERINGA DESC 10 ML UN	0.6634	1.0003	-0.6703	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	31585	RANITIDINA 25 MG/ML 2 ML SI IV IM AP	0.9300	0.9334	-0.0034	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	31585	RANITIDINA 25 MG/ML 2 ML SI IV IM AP	0.9300	0.9334	-0.0034	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	31585	RANITIDINA 25 MG/ML 2 ML SI IV IM AP	0.9300	0.9334	-0.0034	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	31585	RANITIDINA 25 MG/ML 2 ML SI IV IM AP	0.9300	1.8668	-0.9368	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	07587	DRAMIN B6 DL (DIMENIDRINATO + PIRIDOXINA +	11.0637	13.2805	-11.0705	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	19445	CLORETO DE POTASSIO 600 MG CA VO UN	0.9768	1.4605	-0.9705	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	19445	CLORETO DE POTASSIO 600 MG CA VO UN	0.9768	1.4605	-0.9705	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	19445	CLORETO DE POTASSIO 600 MG CA VO UN	0.9768	1.4605	-0.9705	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	27596	TIRA TESTE PARA GLICOSE UN	1.0400	1.0400	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	27596	TIRA TESTE PARA GLICOSE UN	1.0400	2.0800	-1.0400	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	34827	TIORFAN (RACECADOTRILA) 100 MG CA VO UN	3.2000	6.4000	-3.2000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.1060	-0.0060	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.1060	-0.0060	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.1060	-0.0060	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.1060	-0.0060	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.1060	-0.0060	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.1060	-0.0060	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.1060	-0.0060	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.2120	-0.1120	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.2120	-0.1120	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.2120	-0.1120	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.2120	-0.1120	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.2120	-0.1120	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.2120	-0.1120	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.2120	-0.1120	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.2120	-0.1120	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.2120	-0.1120	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.2120	-0.1120	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.2120	-0.1120	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.0000	0.1000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00817	ALGODAO HIDROFILO BOLINHA UN	0.2600	0.1300	0.1300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.0000	0.1000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	08648	ESPARADRAPO 10 X 4.5 CM CM	0.4000	0.0000	0.4000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00426	AGUA BIDESTILADA 10 ML SI IV IM AP	0.8100	0.0000	0.8100	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	13935	METAMUCIL (PLANTAGO OVATA) 5,85 G PO VO E	2.4600	0.0000	2.4600	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	NULL	0.0000	NULL	OPME INVALIDO	2201
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	000435	TAXA DE RESPIRADOR A VOLUME (MAI)	NULL	0.0000	NULL	OPME INVALIDO	2201
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	27060055	UNID EM AFERESE CONCENTRADO DE PLAQUETAS	NULL	0.0000	NULL	OPME INVALIDO	2201
Glosa Min	2018-10-03 00:00:00.000000	01081195	33f0e59d5bdeccc8917e028ac50ea028	NILZA	12811264813	NULL	12811264813	00010014	CONSULTA EM CONSULTORIO MEDICO	0.0000	0.0000	50.0000	GUIA DE CONSULTA NAO EXECUTADA	0622
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12579183644	NULL	12579183644	37761	ALCOOL ETILICO 70 % ST TP ML	0.0600	0.0300	0.0300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12579183644	NULL	12579183644	19119	SERINGA DESC 01 ML (INSULINA) UN	0.6100	0.0000	0.6100	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12579183644	NULL	12579183644	00817	ALGODAO HIDROFILO BOLINHA UN	0.5100	0.2600	0.2500	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12579183644	NULL	12579183644	02720	BOLSA COLETORA (SISTEMA ABERTO) UN	1.2800	0.6400	0.6400	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12579183644	NULL	12579183644	08648	ESPARADRAPO 10 X 4.5 CM CM	0.4000	0.2000	0.2000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12579183644	NULL	12579183644	02720	BOLSA COLETORA (SISTEMA ABERTO) UN	1.2800	0.6400	0.6400	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12579183644	NULL	12579183644	28959	DERSANI LC TP ML	19.4000	14.5500	4.8500	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12579183644	NULL	12579183644	00817	ALGODAO HIDROFILO BOLINHA UN	0.5100	0.2600	0.2500	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	d17b3c5ae418d82694895a326dee545a	ODILIA	12670516743	NULL	12670516743	33219	LUVA DE PROCEDIMENTO UNIDADE UN	1.0000	0.6700	0.3300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	d17b3c5ae418d82694895a326dee545a	ODILIA	12670516743	NULL	12670516743	08648	ESPARADRAPO 10 X 4.5 CM CM	0.4000	0.2000	0.2000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	d17b3c5ae418d82694895a326dee545a	ODILIA	12670516743	NULL	12670516743	37761	ALCOOL ETILICO 70 % ST TP ML	0.0600	0.0200	0.0400	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	d17b3c5ae418d82694895a326dee545a	ODILIA	12670516743	NULL	12670516743	05975	COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER	0.6000	0.3800	0.2200	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	d17b3c5ae418d82694895a326dee545a	ODILIA	12670516743	NULL	12670516743	37761	ALCOOL ETILICO 70 % ST TP ML	0.0300	0.0200	0.0100	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	d17b3c5ae418d82694895a326dee545a	ODILIA	12670516743	NULL	12670516743	00817	ALGODAO HIDROFILO BOLINHA UN	0.2600	0.1300	0.1300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	d17b3c5ae418d82694895a326dee545a	ODILIA	12670516743	NULL	12670516743	00817	ALGODAO HIDROFILO BOLINHA UN	0.2600	0.1300	0.1300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	d17b3c5ae418d82694895a326dee545a	ODILIA	12670516743	NULL	12670516743	30376	BROMETO DE IPRATROPIO 0,25MG/ML SL IN GT	0.0200	0.0000	0.0200	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	d17b3c5ae418d82694895a326dee545a	ODILIA	12670516743	NULL	12670516743	05975	COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER	0.6000	0.3800	0.2200	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	20cbe2e07b1dcd2b6af609a50df7ae80	LUCELENA	12690767849	NULL	12690767849	00817	ALGODAO HIDROFILO BOLINHA UN	0.5100	0.1300	0.3800	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	526685c1041cc1316e874a2e95e67e2e	JOSE	12696604949	NULL	12696604949	55956	CARGA GRAMPEADOR 45MM 6 LINHAS UN	4102.5000	3418.7500	683.7500	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	19151	SERINGA DESC 10 ML UN	0.3300	0.0000	0.3300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	19160	SERINGA DESC 20 ML UN	0.5400	0.0000	0.5400	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.0000	0.1800	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	02720	BOLSA COLETORA (SISTEMA ABERTO) UN	1.2800	0.6400	0.6400	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00485	AGUA BIDESTILADA 500 ML SI IM IV BS	6.4300	0.0000	6.4300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00485	AGUA BIDESTILADA 500 ML SI IM IV BS	6.4300	0.0000	6.4300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	57495	FILTRO BARREIRA E REGENERADOR DE CALOR E UM	24.0000	0.0000	24.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	02720	BOLSA COLETORA (SISTEMA ABERTO) UN	1.2800	0.6400	0.6400	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	02739	BOLSA COLETORA (SISTEMA FECHADO) UN	5.9300	0.0000	5.9300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	52582	CATETER OXIGENIO TIPO OCULOS UN	1.0000	0.0000	1.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	37761	ALCOOL ETILICO 70 % ST TP ML	0.0600	0.0300	0.0300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	57495	FILTRO BARREIRA E REGENERADOR DE CALOR E UM	24.0000	0.0000	24.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	752c651cb4fd049e19c685f87fbe8bdc	EDUARDO	12765990646	NULL	12765990646	37761	ALCOOL ETILICO 70 % ST TP ML	0.0300	0.0200	0.0100	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	08648	ESPARADRAPO 10 X 4.5 CM CM	0.4000	0.2000	0.2000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	08648	ESPARADRAPO 10 X 4.5 CM CM	0.4000	0.2000	0.2000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	31828	PREDNISONA 20 MG CP VO UN	4.4900	1.5000	2.9900	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00817	ALGODAO HIDROFILO BOLINHA UN	0.2600	0.1300	0.1300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	37761	ALCOOL ETILICO 70 % ST TP ML	0.0300	0.0200	0.0100	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	33219	LUVA DE PROCEDIMENTO UNIDADE UN	1.0000	0.6700	0.3300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	22748	LIDOCAINA 2% GE TP OU GR	2.5900	1.3000	1.2900	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	08648	ESPARADRAPO 10 X 4.5 CM CM	0.4000	0.2000	0.2000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	345c226bfea274af1372d41b0305a6c8	ALTINO	12720257940	NULL	12720257940	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.1000	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	345c226bfea274af1372d41b0305a6c8	ALTINO	12720257940	NULL	12720257940	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.1000	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	01081195	e3e6c06b12de2f8beedcf029ac1083bc	ROSANGELA	12641946612	NULL	12641946612	00010014	CONSULTA EM CONSULTORIO MEDICO	0.0000	50.0000	NULL	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	26981	SORO FISIOLOGICO 0,9% 10 ML SI IV AP	0.0000	0.9600	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	24082	BROMOPRIDA 5 MG/ML 2 ML SI IM IV AP	0.0000	2.7300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	24082	BROMOPRIDA 5 MG/ML 2 ML SI IM IV AP	0.0000	2.7300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	24082	BROMOPRIDA 5 MG/ML 2 ML SI IM IV AP	0.0000	2.7300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	24082	BROMOPRIDA 5 MG/ML 2 ML SI IM IV AP	0.0000	2.7300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	01584	NEOSTIGMINA 0,5 MG/ML 1 ML SI IM IV SC AP	0.0000	0.7662	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	01584	NEOSTIGMINA 0,5 MG/ML 1 ML SI IM IV SC AP	0.0000	0.7662	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	01496	FENITOINA 50 MG/ML 5 ML SI IM IV AP	0.0000	2.3400	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	01496	FENITOINA 50 MG/ML 5 ML SI IM IV AP	0.0000	2.3400	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	01496	FENITOINA 50 MG/ML 5 ML SI IM IV AP	0.0000	2.3400	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	01081195	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12811696013	NULL	12811696013	00010014	CONSULTA EM CONSULTORIO MEDICO	0.0000	0.0000	35.0000	GUIA DE CONSULTA NAO EXECUTADA	0622
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12550571048	NULL	12550571048	00817	ALGODAO HIDROFILO BOLINHA UN	0.2600	0.1300	0.1300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12550571048	NULL	12550571048	37761	ALCOOL ETILICO 70 % ST TP ML	0.0300	0.0200	0.0100	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12550571048	NULL	12550571048	37761	ALCOOL ETILICO 70 % ST TP ML	0.0300	0.0200	0.0100	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12550571048	NULL	12550571048	08648	ESPARADRAPO 10 X 4.5 CM CM	0.4000	0.2000	0.2000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12550571048	NULL	12550571048	33219	LUVA DE PROCEDIMENTO UNIDADE UN	1.6700	0.6700	1.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12550571048	NULL	12550571048	37761	ALCOOL ETILICO 70 % ST TP ML	0.0600	0.0200	0.0400	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12550571048	NULL	12550571048	33219	LUVA DE PROCEDIMENTO UNIDADE UN	1.6700	0.6700	1.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	57495	FILTRO BARREIRA E REGENERADOR DE CALOR E UM	24.0000	0.0000	24.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	37761	ALCOOL ETILICO 70 % ST TP ML	0.0300	0.0000	0.0300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	00817	ALGODAO HIDROFILO BOLINHA UN	0.2600	0.0000	0.2600	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	75bcd473a0dc7c7a6751499b38a4a034	JOAQUIM	12692852143	NULL	12692852143	37761	ALCOOL ETILICO 70 % ST TP ML	0.0300	0.0200	0.0100	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	75bcd473a0dc7c7a6751499b38a4a034	JOAQUIM	12692852143	NULL	12692852143	00817	ALGODAO HIDROFILO BOLINHA UN	0.2600	0.1300	0.1300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	75bcd473a0dc7c7a6751499b38a4a034	JOAQUIM	12692852143	NULL	12692852143	08664	ESPARADRAPO MICROPORE 50 X 10 CM CM	0.7700	0.0000	0.7700	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	4668d2494ed6c4b2d18be299efcb26a2	JOAO	12469689344	NULL	12469689344	11193	CLOREXIDINA 2 % ST TP ML	1.3300	0.2700	1.0600	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	32891	EQUIPO POLIFIX 2ş VIAS UN	2.5500	0.0000	2.5500	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	33227	LUVA CIRURGICA PAR UN	1.4500	0.0000	1.4500	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12603877940	NULL	12603877940	00817	ALGODAO HIDROFILO BOLINHA UN	0.1300	0.0000	0.1300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12603877940	NULL	12603877940	00434	AGUA BIDESTILADA 1000 ML SI IM IV BS	8.9000	0.0000	8.9000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	33219	LUVA DE PROCEDIMENTO UNIDADE UN	1.0000	0.6700	0.3300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	08435	EQUIPO P/ BOMBA DE INFUSAO ENTERAL / PARENT	20.2800	0.0000	20.2800	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	33219	LUVA DE PROCEDIMENTO UNIDADE UN	1.0000	0.6700	0.3300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	00817	ALGODAO HIDROFILO BOLINHA UN	0.2600	0.1300	0.1300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	32891	EQUIPO POLIFIX 2ş VIAS UN	5.1000	2.5500	2.5500	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	11193	CLOREXIDINA 2 % ST TP ML	0.8000	0.0000	0.8000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00817	ALGODAO HIDROFILO BOLINHA UN	0.2600	0.1300	0.1300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00817	ALGODAO HIDROFILO BOLINHA UN	0.2600	0.1300	0.1300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	33219	LUVA DE PROCEDIMENTO UNIDADE UN	1.0000	0.6700	0.3300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	08648	ESPARADRAPO 10 X 4.5 CM CM	0.4000	0.0000	0.4000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	33219	LUVA DE PROCEDIMENTO UNIDADE UN	1.0000	0.6700	0.3300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1965b0cdebe9017c3397c8641147759	JOSE	12705413746	NULL	12705413746	32891	EQUIPO POLIFIX 2ş VIAS UN	2.5500	0.0000	2.5500	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1965b0cdebe9017c3397c8641147759	JOSE	12705413746	NULL	12705413746	08664	ESPARADRAPO MICROPORE 50 X 10 CM CM	0.5100	0.3800	0.1300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12558131243	NULL	12558131243	37761	ALCOOL ETILICO 70 % ST TP ML	0.0600	0.0300	0.0300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	37761	ALCOOL ETILICO 70 % ST TP ML	0.0300	0.0200	0.0100	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	7c2bc8cd9bbf9ce081562a3c63fff8c9	MARTA	12647505849	NULL	12647505849	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1756	0.0044	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	f65f553befc0e3bc8bd5bce5c1c6e413	NAIRLENE	12633078944	NULL	12633078944	19160	SERINGA DESC 20 ML UN	0.5400	0.5367	0.0033	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	f65f553befc0e3bc8bd5bce5c1c6e413	NAIRLENE	12633078944	NULL	12633078944	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4067	0.0033	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	f65f553befc0e3bc8bd5bce5c1c6e413	NAIRLENE	12633078944	NULL	12633078944	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4067	0.0033	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	f65f553befc0e3bc8bd5bce5c1c6e413	NAIRLENE	12633078944	NULL	12633078944	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1760	0.0040	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	c2bcdc3cbedb73a0db271ac09d4587a1	ORDETE	12694018147	NULL	12694018147	00817	ALGODAO HIDROFILO BOLINHA UN	0.1300	0.1200	0.0000	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	c2bcdc3cbedb73a0db271ac09d4587a1	ORDETE	12694018147	NULL	12694018147	33219	LUVA DE PROCEDIMENTO UNIDADE UN	1.0000	0.9900	0.0000	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	c2bcdc3cbedb73a0db271ac09d4587a1	ORDETE	12694018147	NULL	12694018147	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1760	0.0040	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	f93cee6f501560245a8f94ffc5c6c246	ROSEDALIA	12622895145	NULL	12622895145	19160	SERINGA DESC 20 ML UN	0.5400	0.5373	0.0027	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	d4089ccef13567fd45b16fb0b60685fa	VERA	12640482546	NULL	12640482546	27480	CLARITROMICINA 500 MG 30 ML PO IV FA	117.1100	117.1050	0.0050	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	d4089ccef13567fd45b16fb0b60685fa	VERA	12640482546	NULL	12640482546	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1754	0.0046	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	d4089ccef13567fd45b16fb0b60685fa	VERA	12640482546	NULL	12640482546	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1754	0.0046	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	eecb3d883747b059c3fe231c34567476	AFFRIDES	12693180144	NULL	12693180144	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4074	0.0026	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	eecb3d883747b059c3fe231c34567476	AFFRIDES	12693180144	NULL	12693180144	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4074	0.0026	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	eecb3d883747b059c3fe231c34567476	AFFRIDES	12693180144	NULL	12693180144	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4074	0.0026	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	eecb3d883747b059c3fe231c34567476	AFFRIDES	12693180144	NULL	12693180144	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4074	0.0026	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	eecb3d883747b059c3fe231c34567476	AFFRIDES	12693180144	NULL	12693180144	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4074	0.0026	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	eecb3d883747b059c3fe231c34567476	AFFRIDES	12693180144	NULL	12693180144	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4074	0.0026	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	eecb3d883747b059c3fe231c34567476	AFFRIDES	12693180144	NULL	12693180144	19160	SERINGA DESC 20 ML UN	0.5400	0.5372	0.0028	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	eecb3d883747b059c3fe231c34567476	AFFRIDES	12693180144	NULL	12693180144	19160	SERINGA DESC 20 ML UN	0.5400	0.5372	0.0028	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	eecb3d883747b059c3fe231c34567476	AFFRIDES	12693180144	NULL	12693180144	19160	SERINGA DESC 20 ML UN	0.5400	0.5372	0.0028	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	eecb3d883747b059c3fe231c34567476	AFFRIDES	12693180144	NULL	12693180144	19160	SERINGA DESC 20 ML UN	0.5400	0.5372	0.0028	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	eecb3d883747b059c3fe231c34567476	AFFRIDES	12693180144	NULL	12693180144	19160	SERINGA DESC 20 ML UN	0.5400	0.5372	0.0028	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	eecb3d883747b059c3fe231c34567476	AFFRIDES	12693180144	NULL	12693180144	19160	SERINGA DESC 20 ML UN	0.5400	0.5372	0.0028	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	eecb3d883747b059c3fe231c34567476	AFFRIDES	12693180144	NULL	12693180144	19160	SERINGA DESC 20 ML UN	0.5400	0.5372	0.0028	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1d6bbb4a00130e2e654e830fc9bae6a	ALEXANDRINA	12694224940	NULL	12694224940	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4072	0.0028	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1d6bbb4a00130e2e654e830fc9bae6a	ALEXANDRINA	12694224940	NULL	12694224940	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4072	0.0028	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1d6bbb4a00130e2e654e830fc9bae6a	ALEXANDRINA	12694224940	NULL	12694224940	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4072	0.0028	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1d6bbb4a00130e2e654e830fc9bae6a	ALEXANDRINA	12694224940	NULL	12694224940	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4072	0.0028	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1d6bbb4a00130e2e654e830fc9bae6a	ALEXANDRINA	12694224940	NULL	12694224940	19160	SERINGA DESC 20 ML UN	0.5400	0.5358	0.0042	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1d6bbb4a00130e2e654e830fc9bae6a	ALEXANDRINA	12694224940	NULL	12694224940	19160	SERINGA DESC 20 ML UN	0.5400	0.5367	0.0033	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1d6bbb4a00130e2e654e830fc9bae6a	ALEXANDRINA	12694224940	NULL	12694224940	19160	SERINGA DESC 20 ML UN	0.5400	0.5367	0.0033	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1d6bbb4a00130e2e654e830fc9bae6a	ALEXANDRINA	12694224940	NULL	12694224940	19160	SERINGA DESC 20 ML UN	0.5400	0.5367	0.0033	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1d6bbb4a00130e2e654e830fc9bae6a	ALEXANDRINA	12694224940	NULL	12694224940	19160	SERINGA DESC 20 ML UN	0.5400	0.5367	0.0033	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	345c226bfea274af1372d41b0305a6c8	ALTINO	12720257940	NULL	12720257940	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.1000	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	345c226bfea274af1372d41b0305a6c8	ALTINO	12720257940	NULL	12720257940	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.1000	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	345c226bfea274af1372d41b0305a6c8	ALTINO	12720257940	NULL	12720257940	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.1000	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.1038	-0.0038	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.1038	-0.0038	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.1038	-0.0038	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.1038	-0.0038	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.1038	-0.0038	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	19160	SERINGA DESC 20 ML UN	0.5400	0.5384	0.0016	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	19160	SERINGA DESC 20 ML UN	0.5400	0.5378	0.0022	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	19160	SERINGA DESC 20 ML UN	0.5400	0.5378	0.0022	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	19160	SERINGA DESC 20 ML UN	0.5400	0.5378	0.0022	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	19160	SERINGA DESC 20 ML UN	0.5400	0.5378	0.0022	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1797	0.0003	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1797	0.0003	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1797	0.0003	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1900	0.1797	0.0103	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1900	0.1797	0.0103	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	00426	AGUA BIDESTILADA 10 ML SI IV IM AP	0.4000	0.4045	-0.0045	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	00426	AGUA BIDESTILADA 10 ML SI IV IM AP	0.8100	0.8091	0.0009	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	752c651cb4fd049e19c685f87fbe8bdc	EDUARDO	12765990646	NULL	12765990646	33219	LUVA DE PROCEDIMENTO UNIDADE UN	4.3300	1.6700	2.6600	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12550571048	NULL	12550571048	53660	EQUIPO MACRO-GOTAS FLEXIVEL C/ INJETOR LATE	1.5900	0.0000	1.5900	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12550571048	NULL	12550571048	05975	COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER	0.3000	0.0000	0.3000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12550571048	NULL	12550571048	05975	COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER	0.6000	0.1500	0.4500	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12550571048	NULL	12550571048	05975	COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER	0.3000	0.0000	0.3000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	d2d55454dccb89ec02f576d653ebb2aa	IRACI	12693519245	NULL	12693519245	33219	LUVA DE PROCEDIMENTO UNIDADE UN	1.0000	0.9900	0.0000	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	670141098c0309ac9be3db204bdc12cf	LEOSINA	12706525442	NULL	12706525442	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4000	0.0000	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	20cbe2e07b1dcd2b6af609a50df7ae80	LUCELENA	12690767849	NULL	12690767849	08435	EQUIPO P/ BOMBA DE INFUSAO ENTERAL / PARENT	60.8400	60.8300	0.0000	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	20cbe2e07b1dcd2b6af609a50df7ae80	LUCELENA	12690767849	NULL	12690767849	37761	ALCOOL ETILICO 70 % ST TP ML	0.0300	0.0000	0.0300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	20cbe2e07b1dcd2b6af609a50df7ae80	LUCELENA	12690767849	NULL	12690767849	27480	CLARITROMICINA 500 MG 30 ML PO IV FA	117.1100	117.1050	0.0050	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	20cbe2e07b1dcd2b6af609a50df7ae80	LUCELENA	12690767849	NULL	12690767849	27480	CLARITROMICINA 500 MG 30 ML PO IV FA	117.1100	117.1050	0.0050	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	20cbe2e07b1dcd2b6af609a50df7ae80	LUCELENA	12690767849	NULL	12690767849	27480	CLARITROMICINA 500 MG 30 ML PO IV FA	117.1100	117.1050	0.0050	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	20cbe2e07b1dcd2b6af609a50df7ae80	LUCELENA	12690767849	NULL	12690767849	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1758	0.0042	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	20cbe2e07b1dcd2b6af609a50df7ae80	LUCELENA	12690767849	NULL	12690767849	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1758	0.0042	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	20cbe2e07b1dcd2b6af609a50df7ae80	LUCELENA	12690767849	NULL	12690767849	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1758	0.0042	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	20cbe2e07b1dcd2b6af609a50df7ae80	LUCELENA	12690767849	NULL	12690767849	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1758	0.0042	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	20cbe2e07b1dcd2b6af609a50df7ae80	LUCELENA	12690767849	NULL	12690767849	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1758	0.0042	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	20cbe2e07b1dcd2b6af609a50df7ae80	LUCELENA	12690767849	NULL	12690767849	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1758	0.0042	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	20cbe2e07b1dcd2b6af609a50df7ae80	LUCELENA	12690767849	NULL	12690767849	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4084	0.0016	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	20cbe2e07b1dcd2b6af609a50df7ae80	LUCELENA	12690767849	NULL	12690767849	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4084	0.0016	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	20cbe2e07b1dcd2b6af609a50df7ae80	LUCELENA	12690767849	NULL	12690767849	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4084	0.0016	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	20cbe2e07b1dcd2b6af609a50df7ae80	LUCELENA	12690767849	NULL	12690767849	19160	SERINGA DESC 20 ML UN	0.5400	0.5384	0.0016	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	19445	CLORETO DE POTASSIO 600 MG CA VO UN	0.4900	0.4867	0.0033	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	19445	CLORETO DE POTASSIO 600 MG CA VO UN	0.4900	0.4867	0.0033	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4075	0.0025	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4075	0.0025	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4075	0.0025	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	07269	DIPIRONA 500 MG/ML 2 ML SI IV IM AP	0.6900	0.6865	0.0035	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	07269	DIPIRONA 500 MG/ML 2 ML SI IV IM AP	0.6900	0.6865	0.0035	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	07269	DIPIRONA 500 MG/ML 2 ML SI IV IM AP	0.6900	0.6865	0.0035	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	07269	DIPIRONA 500 MG/ML 2 ML SI IV IM AP	0.6900	0.6865	0.0035	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	07269	DIPIRONA 500 MG/ML 2 ML SI IV IM AP	0.6900	0.6865	0.0035	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	07269	DIPIRONA 500 MG/ML 2 ML SI IV IM AP	0.6900	0.6865	0.0035	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	07269	DIPIRONA 500 MG/ML 2 ML SI IV IM AP	0.6900	0.6865	0.0035	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	07269	DIPIRONA 500 MG/ML 2 ML SI IV IM AP	0.6900	0.6865	0.0035	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1769	0.0031	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1769	0.0031	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1769	0.0031	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00426	AGUA BIDESTILADA 10 ML SI IV IM AP	0.8100	0.8073	0.0027	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00426	AGUA BIDESTILADA 10 ML SI IV IM AP	0.8100	0.8073	0.0027	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	19160	SERINGA DESC 20 ML UN	0.5400	0.5372	0.0028	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	19160	SERINGA DESC 20 ML UN	0.5400	0.5372	0.0028	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	19160	SERINGA DESC 20 ML UN	0.5400	0.5372	0.0028	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	19160	SERINGA DESC 20 ML UN	0.5400	0.5372	0.0028	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	19160	SERINGA DESC 20 ML UN	0.5400	0.5372	0.0028	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	19160	SERINGA DESC 20 ML UN	0.5400	0.5372	0.0028	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	19160	SERINGA DESC 20 ML UN	0.5400	0.5372	0.0028	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1761	0.0039	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1779	0.0021	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1779	0.0021	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1779	0.0021	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1779	0.0021	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1779	0.0021	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1779	0.0021	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1779	0.0021	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	08664	ESPARADRAPO MICROPORE 50 X 10 CM CM	0.2600	0.2558	0.0042	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	08664	ESPARADRAPO MICROPORE 50 X 10 CM CM	0.2600	0.2558	0.0042	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	e2b254ce765be196b019032789d8f852	MARIA	12576216044	NULL	12576216044	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4078	0.0022	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	19135	SERINGA DESC 03 ML UN	0.1500	0.0000	0.1500	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	19135	SERINGA DESC 03 ML UN	0.1500	0.0000	0.1500	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	53660	EQUIPO MACRO-GOTAS FLEXIVEL C/ INJETOR LATE	1.5900	0.0000	1.5900	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	19135	SERINGA DESC 03 ML UN	0.1500	0.0000	0.1500	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	d17b3c5ae418d82694895a326dee545a	ODILIA	12670516743	NULL	12670516743	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1774	0.0026	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	d17b3c5ae418d82694895a326dee545a	ODILIA	12670516743	NULL	12670516743	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1774	0.0026	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	11193	CLOREXIDINA 2 % ST TP ML	3.2000	0.8000	2.4000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	20559	SORO FISIOLOGICO 0,9% 250 ML SI IV BS	11.8300	3.9400	7.8900	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00035	ABOCATH (CATETER INTRAVENOSO) N. 14 A 22 UN	11.3000	3.7700	7.5300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	6ccea6ac8c216c032723aee73a9f81c9	PRISCILA	12662249242	NULL	12662249242	20672	SORO RINGER SIMPLES 500 ML SI IV BS	5.9400	5.9375	0.0025	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	6ccea6ac8c216c032723aee73a9f81c9	PRISCILA	12662249242	NULL	12662249242	20672	SORO RINGER SIMPLES 500 ML SI IV BS	5.9400	5.9375	0.0025	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	6ccea6ac8c216c032723aee73a9f81c9	PRISCILA	12662249242	NULL	12662249242	07269	DIPIRONA 500 MG/ML 2 ML SI IV IM AP	0.6900	0.6864	0.0036	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	6ccea6ac8c216c032723aee73a9f81c9	PRISCILA	12662249242	NULL	12662249242	07269	DIPIRONA 500 MG/ML 2 ML SI IV IM AP	0.6900	0.6864	0.0036	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	6ccea6ac8c216c032723aee73a9f81c9	PRISCILA	12662249242	NULL	12662249242	19160	SERINGA DESC 20 ML UN	0.5400	0.5373	0.0027	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.1000	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.1000	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.1000	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.1000	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.1000	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.1000	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.1000	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.1000	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.1000	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.1000	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.1000	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.1000	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.3100	0.3000	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00426	AGUA BIDESTILADA 10 ML SI IV IM AP	0.4000	0.0000	0.4000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00426	AGUA BIDESTILADA 10 ML SI IV IM AP	0.8100	0.0000	0.8100	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1766	0.0034	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	33227	LUVA CIRURGICA PAR UN	1.4500	1.4476	0.0024	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	33227	LUVA CIRURGICA PAR UN	1.4500	1.4476	0.0024	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	33227	LUVA CIRURGICA PAR UN	1.4500	1.4476	0.0024	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	19160	SERINGA DESC 20 ML UN	0.5400	0.5384	0.0016	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	19160	SERINGA DESC 20 ML UN	0.5400	0.5384	0.0016	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	32891	EQUIPO POLIFIX 2ş VIAS UN	2.5500	2.5500	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1776	0.0024	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1776	0.0024	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	00426	AGUA BIDESTILADA 10 ML SI IV IM AP	0.8100	0.8092	0.0008	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	00426	AGUA BIDESTILADA 10 ML SI IV IM AP	0.8100	0.8092	0.0008	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	00426	AGUA BIDESTILADA 10 ML SI IV IM AP	0.8100	0.8092	0.0008	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	11193	CLOREXIDINA 2 % ST TP ML	0.5300	0.5300	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	11193	CLOREXIDINA 2 % ST TP ML	0.5300	0.5300	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	6799aa3de305405ab065aad5b599765c	VANIR	12700232345	NULL	12700232345	07269	DIPIRONA 500 MG/ML 2 ML SI IV IM AP	0.6900	0.6870	0.0030	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	6799aa3de305405ab065aad5b599765c	VANIR	12700232345	NULL	12700232345	07269	DIPIRONA 500 MG/ML 2 ML SI IV IM AP	0.6900	0.6870	0.0030	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	29661	NOREPINEFRINA 2 MG/ML 4 ML SI IV AP	37.9900	37.9850	0.0050	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00426	AGUA BIDESTILADA 10 ML SI IV IM AP	0.8100	0.8079	0.0021	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00426	AGUA BIDESTILADA 10 ML SI IV IM AP	0.8100	0.8079	0.0021	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	75bcd473a0dc7c7a6751499b38a4a034	JOAQUIM	12692852143	NULL	12692852143	37761	ALCOOL ETILICO 70 % ST TP ML	0.0300	0.0200	0.0100	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	610c198ec4c064687cf0524f147d3aed	ROBERTO	12748814743	NULL	12748814743	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1767	0.0033	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	610c198ec4c064687cf0524f147d3aed	ROBERTO	12748814743	NULL	12748814743	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1767	0.0033	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	610c198ec4c064687cf0524f147d3aed	ROBERTO	12748814743	NULL	12748814743	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4083	0.0017	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	610c198ec4c064687cf0524f147d3aed	ROBERTO	12748814743	NULL	12748814743	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4083	0.0017	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	610c198ec4c064687cf0524f147d3aed	ROBERTO	12748814743	NULL	12748814743	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4083	0.0017	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	610c198ec4c064687cf0524f147d3aed	ROBERTO	12748814743	NULL	12748814743	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4083	0.0017	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	dd486d36a88cfef0b44fe652638a0164	DELFINA	12660326244	NULL	12660326244	00487	RANITIDINA 25 MG/ML 2 ML SI IM IV AP	0.0000	0.9300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12647284040	NULL	12647284040	08664	ESPARADRAPO MICROPORE 50 X 10 CM CM	0.7700	0.7667	0.0033	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12647284040	NULL	12647284040	20567	SORO FISIOLOGICO 0,9% 500 ML SI IV BS	9.4700	9.4697	0.0003	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12647284040	NULL	12647284040	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4086	0.0014	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12647284040	NULL	12647284040	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4086	0.0014	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12647284040	NULL	12647284040	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4086	0.0014	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	01081195	89cf7f30a66e6c1645adaac3ceeb8c40	SELMA	12812118918	NULL	12812118918	00010014	CONSULTA EM CONSULTORIO MEDICO	0.0000	35.0000	NULL	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	2a44e66e1f44091701d47a8515178d89	DIVA	12747785048	NULL	12747785048	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1700	0.0000	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	b53746577aa9f227f1671c3aee8e9ec0	ITAJAYR	12708811845	NULL	12708811845	999999	DESPESAS HOSPITALARES DIVERSAS	1777.2500	917.8767	859.3733	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	6.8145	-3.4045	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	6.8145	-3.4045	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	6.8145	-3.4045	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	6.8145	-3.4045	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	6.8145	-3.4045	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	6.8145	-3.4045	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	6.8145	-3.4045	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4072	0.0028	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4072	0.0028	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4072	0.0028	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4072	0.0028	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.2100	-0.1100	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.2120	-0.1120	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.2120	-0.1120	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.2120	-0.1120	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	19160	SERINGA DESC 20 ML UN	0.5400	0.5374	0.0026	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	19160	SERINGA DESC 20 ML UN	0.5400	0.5374	0.0026	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	19160	SERINGA DESC 20 ML UN	0.5400	0.5374	0.0026	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	19160	SERINGA DESC 20 ML UN	0.5400	0.5374	0.0026	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00426	AGUA BIDESTILADA 10 ML SI IV IM AP	0.4000	0.4037	-0.0037	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00426	AGUA BIDESTILADA 10 ML SI IV IM AP	0.4000	0.4037	-0.0037	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00426	AGUA BIDESTILADA 10 ML SI IV IM AP	0.4000	0.4037	-0.0037	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00426	AGUA BIDESTILADA 10 ML SI IV IM AP	0.4000	0.4037	-0.0037	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00426	AGUA BIDESTILADA 10 ML SI IV IM AP	0.8100	0.8073	0.0027	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00426	AGUA BIDESTILADA 10 ML SI IV IM AP	0.8100	0.8073	0.0027	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00426	AGUA BIDESTILADA 10 ML SI IV IM AP	0.8100	0.8073	0.0027	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00426	AGUA BIDESTILADA 10 ML SI IV IM AP	0.8100	0.8073	0.0027	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00426	AGUA BIDESTILADA 10 ML SI IV IM AP	0.8100	0.8073	0.0027	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00434	AGUA BIDESTILADA 1000 ML SI IM IV BS	62.3000	71.2000	-62.3000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	09636	FLORATIL (SACCHAROMYCES BOULARDII) 200 MG P	4.4400	8.8851	-4.4451	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	09636	FLORATIL (SACCHAROMYCES BOULARDII) 200 MG P	4.4400	8.8851	-4.4451	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	09636	FLORATIL (SACCHAROMYCES BOULARDII) 200 MG P	4.4400	8.8851	-4.4451	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	09636	FLORATIL (SACCHAROMYCES BOULARDII) 200 MG P	4.4400	8.8851	-4.4451	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	05975	COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER	0.7739	0.8059	-0.7759	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	05975	COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER	1.3439	1.3948	-0.7948	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	05975	COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER	1.3439	1.3948	-0.7948	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	28959	DERSANI LC TP ML	13.5800	14.5500	-4.8500	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	28959	DERSANI LC TP ML	13.5800	14.5500	-4.8500	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	55018	ALGINATO DE CALCIO EM HIDROGEL GL TP GR	17.2500	17.2500	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	08664	ESPARADRAPO MICROPORE 50 X 10 CM CM	1.1064	1.1285	-0.8685	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	08664	ESPARADRAPO MICROPORE 50 X 10 CM CM	1.3564	1.3849	-0.8749	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	08664	ESPARADRAPO MICROPORE 50 X 10 CM CM	1.3564	1.3849	-0.8749	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	08664	ESPARADRAPO MICROPORE 50 X 10 CM CM	1.3564	1.3849	-0.8749	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	08664	ESPARADRAPO MICROPORE 50 X 10 CM CM	1.3564	1.3849	-0.8749	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1d6bbb4a00130e2e654e830fc9bae6a	ALEXANDRINA	12694224940	NULL	12694224940	999999	INSUMOS 40080200	NULL	0.0000	NULL	OPME INVALIDO	2201
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	03280	CLOREXIDINA 2 % ST TP ML	NULL	0.0000	NULL	OPME INVALIDO	2201
Glosa Min	2018-10-03 00:00:00.000000	1084117	800720d33fe0defb6121e82dd216d044	JALMO	12786952647	NULL	12786952647	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	800720d33fe0defb6121e82dd216d044	JALMO	12786952647	NULL	12786952647	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	800720d33fe0defb6121e82dd216d044	JALMO	12786952647	NULL	12786952647	00487	RANITIDINA 25 MG/ML 2 ML SI IM IV AP	0.0000	0.9300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	800720d33fe0defb6121e82dd216d044	JALMO	12786952647	NULL	12786952647	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1800	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	800720d33fe0defb6121e82dd216d044	JALMO	12786952647	NULL	12786952647	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1800	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	800720d33fe0defb6121e82dd216d044	JALMO	12786952647	NULL	12786952647	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1800	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	800720d33fe0defb6121e82dd216d044	JALMO	12786952647	NULL	12786952647	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1800	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	800720d33fe0defb6121e82dd216d044	JALMO	12786952647	NULL	12786952647	51588	ESPARADRAPO MICROPORE 50 X 10 CM CM	0.0000	1.5400	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	800720d33fe0defb6121e82dd216d044	JALMO	12786952647	NULL	12786952647	00757	CEFUROXIMA 750 MG + DIL. 6 ML PO IM IV FA	0.0000	26.1300	NULL	VALOR APRESENTADO A MAIOR	1705
Glosa Min	2018-10-03 00:00:00.000000	1084117	800720d33fe0defb6121e82dd216d044	JALMO	12786952647	NULL	12786952647	00090	SERINGA DESC 20 ML UN	0.0000	0.5400	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	800720d33fe0defb6121e82dd216d044	JALMO	12786952647	NULL	12786952647	00090	SERINGA DESC 20 ML UN	0.0000	0.5400	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	752c651cb4fd049e19c685f87fbe8bdc	EDUARDO	12765990646	NULL	12765990646	00172	SORO FISIOLOGICO 0,9% 500 ML SI IV BS	0.0000	9.4700	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	752c651cb4fd049e19c685f87fbe8bdc	EDUARDO	12765990646	NULL	12765990646	00172	SORO FISIOLOGICO 0,9% 500 ML SI IV BS	0.0000	9.4700	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	752c651cb4fd049e19c685f87fbe8bdc	EDUARDO	12765990646	NULL	12765990646	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	752c651cb4fd049e19c685f87fbe8bdc	EDUARDO	12765990646	NULL	12765990646	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.0000	0.6875	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	752c651cb4fd049e19c685f87fbe8bdc	EDUARDO	12765990646	NULL	12765990646	53975	Hemifumarato De Quetiapina 25mg ? Cp	0.0000	1.2450	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	752c651cb4fd049e19c685f87fbe8bdc	EDUARDO	12765990646	NULL	12765990646	54995	EQUIPO P/ BOMBA DE INFUSAO ENTERAL / PARENTERAL U UN	0.0000	0.0000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12558131243	NULL	12558131243	00172	SORO FISIOLOGICO 0,9% 500 ML SI IV BS	0.0000	9.4700	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12558131243	NULL	12558131243	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1758	NULL	VALOR APRESENTADO A MAIOR	1705
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12558131243	NULL	12558131243	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1757	NULL	VALOR APRESENTADO A MAIOR	1705
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12558131243	NULL	12558131243	52010341	Hérnia Discal - Tratamento Cirúrgico	0.0000	0.0000	NULL	COBRANCA DE HONORARIOS EM DUPLICIDADE	2607
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12558131243	NULL	12558131243	52010511	Fratura do Cóccix - Tratamento Cruento	0.0000	0.0000	NULL	COBRANCA DE HONORARIOS EM DUPLICIDADE	2607
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12558131243	NULL	12558131243	52010511	Fratura do Cóccix - Tratamento Cruento	0.0000	0.0000	NULL	COBRANCA DE HONORARIOS EM DUPLICIDADE	2607
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12558131243	NULL	12558131243	52010511	Fratura do Cóccix - Tratamento Cruento	0.0000	0.0000	NULL	COBRANCA DE HONORARIOS EM DUPLICIDADE	2607
Glosa Min	2018-10-03 00:00:00.000000	1084117	526685c1041cc1316e874a2e95e67e2e	JOSE	12696604949	NULL	12696604949	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1760	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	11232	CLEXANE (ENOXAPARINA) 40 MG SI IV SC SE	0.0000	38.9400	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	11232	CLEXANE (ENOXAPARINA) 40 MG SI IV SC SE	0.0000	38.9400	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	11325	EQUIPO MACRO-GOTAS FLEXIVEL C/ INJETOR LATERAL UN	0.0000	4.7700	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00404	LACTULOSE 667 MG/ML XP VO ML	0.0000	4.2900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.0000	0.0000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.0000	0.0000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.0000	0.0000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.0000	0.4000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.0000	0.4000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.0000	0.4000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.0000	0.4000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	51163	AGUA BIDESTILADA 250 ML	0.0000	5.7900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	51163	AGUA BIDESTILADA 250 ML	0.0000	5.7900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	51164	AGUA BIDESTILADA 500 ML	0.0000	6.4300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.0000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	51379	SERINGA DESC 05 ML UN	0.0000	0.1900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	51434	BECLOMETASONA 400 MCG / ML 2 ML SL IN FL	0.0000	4.4800	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	51434	BECLOMETASONA 400 MCG / ML 2 ML SL IN FL	0.0000	4.4800	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	51434	BECLOMETASONA 400 MCG / ML 2 ML SL IN FL	0.0000	4.4800	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	51434	BECLOMETASONA 400 MCG / ML 2 ML SL IN FL	0.0000	4.4800	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	51434	BECLOMETASONA 400 MCG / ML 2 ML SL IN FL	0.0000	4.4800	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	51622	MODULO DE PROTEINAS DO SORO DO LEITE PO EN GR	0.0000	6.6000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	51660	BROMETO DE IPRATROPIO SL IN GT	0.0000	1.2008	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	51660	BROMETO DE IPRATROPIO SL IN GT	0.0000	0.0000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	51710	CLORETO DE POTASSIO 15% 10 ML SI IV AP	0.0000	1.3700	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	52403	MORFINA 1 MG/ML 2 ML SI IM IT IV PE AP	0.0000	3.9900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00943	EQUIPO POLIFIX 2 VIAS UN	0.0000	5.1000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00992	ESPIRONOLACTONA 25 MG CP VO UN	0.0000	0.4800	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00992	ESPIRONOLACTONA 25 MG CP VO UN	0.0000	0.4800	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	01691	NISTATINA 100.000 UI/ML SU VO ML	0.0000	0.3000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	4e13adf421809cb755e1bdd80cc4efed	AGRIPINA	12385409142	NULL	12385409142	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	4e13adf421809cb755e1bdd80cc4efed	AGRIPINA	12385409142	NULL	12385409142	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	4e13adf421809cb755e1bdd80cc4efed	AGRIPINA	12385409142	NULL	12385409142	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	4e13adf421809cb755e1bdd80cc4efed	AGRIPINA	12385409142	NULL	12385409142	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.0000	0.4000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	4e13adf421809cb755e1bdd80cc4efed	AGRIPINA	12385409142	NULL	12385409142	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.0000	0.4000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	75bcd473a0dc7c7a6751499b38a4a034	JOAQUIM	12692852143	NULL	12692852143	101001	DIARIA DE ENFERMARIA	0.0000	1733.2400	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	75bcd473a0dc7c7a6751499b38a4a034	JOAQUIM	12692852143	NULL	12692852143	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4075	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	75bcd473a0dc7c7a6751499b38a4a034	JOAQUIM	12692852143	NULL	12692852143	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4075	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	75bcd473a0dc7c7a6751499b38a4a034	JOAQUIM	12692852143	NULL	12692852143	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	75bcd473a0dc7c7a6751499b38a4a034	JOAQUIM	12692852143	NULL	12692852143	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4075	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	75bcd473a0dc7c7a6751499b38a4a034	JOAQUIM	12692852143	NULL	12692852143	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4075	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	75bcd473a0dc7c7a6751499b38a4a034	JOAQUIM	12692852143	NULL	12692852143	01652	TRAMADOL 50 MG CP VO UN	0.0000	1.9272	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	75bcd473a0dc7c7a6751499b38a4a034	JOAQUIM	12692852143	NULL	12692852143	01652	TRAMADOL 50 MG CP VO UN	0.0000	1.9272	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	75bcd473a0dc7c7a6751499b38a4a034	JOAQUIM	12692852143	NULL	12692852143	00172	SORO FISIOLOGICO 0,9% 500 ML SI IV BS	0.0000	4.7300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	75bcd473a0dc7c7a6751499b38a4a034	JOAQUIM	12692852143	NULL	12692852143	00172	SORO FISIOLOGICO 0,9% 500 ML SI IV BS	0.0000	4.7300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	75bcd473a0dc7c7a6751499b38a4a034	JOAQUIM	12692852143	NULL	12692852143	21010099	Revisão de Lâmina	0.0000	0.0000	NULL	COBRANCA DE HONORARIOS EM DUPLICIDADE	2607
Glosa Min	2018-10-03 00:00:00.000000	1084117	75bcd473a0dc7c7a6751499b38a4a034	JOAQUIM	12692852143	NULL	12692852143	34010068	Tomografia Comp. de Crânio	0.0000	0.0000	NULL	EXAME SEM REGISTRO DE EXECUCAO	2703
Glosa Min	2018-10-03 00:00:00.000000	1084117	75bcd473a0dc7c7a6751499b38a4a034	JOAQUIM	12692852143	NULL	12692852143	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.0000	0.6850	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	75bcd473a0dc7c7a6751499b38a4a034	JOAQUIM	12692852143	NULL	12692852143	04073	TRAMADOL 50 MG 1 ML SI IM IV AP	0.0000	4.1900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	75bcd473a0dc7c7a6751499b38a4a034	JOAQUIM	12692852143	NULL	12692852143	04073	TRAMADOL 50 MG 1 ML SI IM IV AP	0.0000	4.1900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	75bcd473a0dc7c7a6751499b38a4a034	JOAQUIM	12692852143	NULL	12692852143	04073	TRAMADOL 50 MG 1 ML SI IM IV AP	0.0000	4.1900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00124	LUVA CIRURGICA UN	0.0000	1.4475	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00124	LUVA CIRURGICA UN	0.0000	1.4475	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00124	LUVA CIRURGICA UN	0.0000	1.4475	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00124	LUVA CIRURGICA UN	0.0000	1.4475	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	26981	SORO FISIOLOGICO 0,9% 10 ML SI IV AP	0.0000	0.4800	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	26981	SORO FISIOLOGICO 0,9% 10 ML SI IV AP	0.0000	0.9600	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	26981	SORO FISIOLOGICO 0,9% 10 ML SI IV AP	0.0000	0.9600	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	03280	CLOREXIDINA 2 % ST TP ML	0.0000	0.5300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.0000	0.6875	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.0000	0.6875	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.0000	0.6875	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00487	RANITIDINA 25 MG/ML 2 ML SI IM IV AP	0.0000	0.9300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00487	RANITIDINA 25 MG/ML 2 ML SI IM IV AP	0.0000	0.9300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00487	RANITIDINA 25 MG/ML 2 ML SI IM IV AP	0.0000	0.9300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	51578	Frasco p/ alimentacao enteral	0.0000	2.4700	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	51584	ESPARADRAPO MICROPORE	0.0000	0.2560	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	51584	ESPARADRAPO MICROPORE	0.0000	0.2560	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	55795	FOSFATO DE POTASSIO 2 MEQ/ML 10 ML SI IV AP	0.0000	3.0200	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00069	SERINGA DESC 10 ML UN	0.0000	0.6700	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4088	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4088	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4088	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4088	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4088	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4088	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4088	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4088	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4088	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4088	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	02246	HIDROCORTISONA 100 MG PO IM IV FA	0.0000	2.8300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.0000	0.6872	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.0000	0.6872	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.0000	0.6872	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.0000	0.6872	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.0000	0.6872	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1766	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1766	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4070	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	22421	PIPERACILINA 2 G + TAZOBACTAM 250 MG 30 ML PO IV	0.0000	55.3400	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	22421	PIPERACILINA 2 G + TAZOBACTAM 250 MG 30 ML PO IV	0.0000	55.3400	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	25030019	Distúrbios Circulatórios Artério - Venosos e Linfáticos	0.0000	183.3600	NULL	VALOR APRESENTADO A MAIOR	1705
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	35382	COMPRESSAS DE GASES 7.5 X7,5 (11 FIOS ESTERIL) UN	0.0000	0.3000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	000445	TAXA DE TRANSPORTE E INSTALACAO DE EQUIPAMENTO DE	0.0000	0.0000	NULL	COBRANCA DE TAXAS, DE SERVICOS REALIZADOS EM AMBIENTES INCOMPATIVEIS COM O USO DE EQUIPAMENTOS	2407
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.0000	0.4000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	51508	ENCRISE (ARGIPRESSINA) 20 U/ML 1 ML SI IM IV SC AP	0.0000	20.1200	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	51508	ENCRISE (ARGIPRESSINA) 20 U/ML 1 ML SI IM IV SC AP	0.0000	20.1200	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	51584	ESPARADRAPO MICROPORE	0.0000	0.2560	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	51584	ESPARADRAPO MICROPORE	0.0000	0.2560	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	cd2840524be5a3f1d0939f241e24f32b	MARIA	12705908340	NULL	12705908340	00181	SULFATO DE MAGNESIO 100 MG/ML 10 ML SI IM IV	0.0000	0.9467	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	cd2840524be5a3f1d0939f241e24f32b	MARIA	12705908340	NULL	12705908340	00184	CLORETO DE POTASSIO 10% 10 ML SI IV AP	0.0000	0.2967	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	cd2840524be5a3f1d0939f241e24f32b	MARIA	12705908340	NULL	12705908340	25030019	Distúrbios Circulatórios Artério - Venosos e Linfáticos	0.0000	0.0000	NULL	EXAME SEM REGISTRO DE EXECUCAO	2703
Glosa Min	2018-10-03 00:00:00.000000	1084117	cd2840524be5a3f1d0939f241e24f32b	MARIA	12705908340	NULL	12705908340	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	cd2840524be5a3f1d0939f241e24f32b	MARIA	12705908340	NULL	12705908340	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	cd2840524be5a3f1d0939f241e24f32b	MARIA	12705908340	NULL	12705908340	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12550571048	NULL	12550571048	00090	SERINGA DESC 20 ML UN	0.0000	0.5379	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12550571048	NULL	12550571048	00090	SERINGA DESC 20 ML UN	0.0000	0.5379	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12550571048	NULL	12550571048	00090	SERINGA DESC 20 ML UN	0.0000	0.5379	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	9ffbbf7340bbd65e9e3baa9406d027f3	MARCO	12261811645	NULL	12261811645	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	9ffbbf7340bbd65e9e3baa9406d027f3	MARCO	12261811645	NULL	12261811645	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	9ffbbf7340bbd65e9e3baa9406d027f3	MARCO	12261811645	NULL	12261811645	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	9ffbbf7340bbd65e9e3baa9406d027f3	MARCO	12261811645	NULL	12261811645	01611	CLORETO DE POTASSIO 600 MG CA VO UN	0.0000	0.4867	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	9ffbbf7340bbd65e9e3baa9406d027f3	MARCO	12261811645	NULL	12261811645	01611	CLORETO DE POTASSIO 600 MG CA VO UN	0.0000	0.4867	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	9ffbbf7340bbd65e9e3baa9406d027f3	MARCO	12261811645	NULL	12261811645	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.0000	0.8078	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	9ffbbf7340bbd65e9e3baa9406d027f3	MARCO	12261811645	NULL	12261811645	51208	SORO RINGER SIMPLES 500 ML SI IV BS	0.0000	5.9400	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	9ffbbf7340bbd65e9e3baa9406d027f3	MARCO	12261811645	NULL	12261811645	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1800	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	9ffbbf7340bbd65e9e3baa9406d027f3	MARCO	12261811645	NULL	12261811645	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1773	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	9ffbbf7340bbd65e9e3baa9406d027f3	MARCO	12261811645	NULL	12261811645	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1773	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4094	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4094	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4094	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	01496	FENITOINA 50 MG/ML 5 ML SI IM IV AP	0.0000	2.3400	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	25030019	Distúrbios Circulatórios Artério - Venosos e Linfáticos	0.0000	117.1821	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	26981	SORO FISIOLOGICO 0,9% 10 ML SI IV AP	0.0000	0.4800	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	26981	SORO FISIOLOGICO 0,9% 10 ML SI IV AP	0.0000	0.4800	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	26981	SORO FISIOLOGICO 0,9% 10 ML SI IV AP	0.0000	0.9600	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	26981	SORO FISIOLOGICO 0,9% 10 ML SI IV AP	0.0000	0.9600	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	26981	SORO FISIOLOGICO 0,9% 10 ML SI IV AP	0.0000	0.9600	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	26981	SORO FISIOLOGICO 0,9% 10 ML SI IV AP	0.0000	0.9600	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	26981	SORO FISIOLOGICO 0,9% 10 ML SI IV AP	0.0000	0.9600	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	26981	SORO FISIOLOGICO 0,9% 10 ML SI IV AP	0.0000	0.9600	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	26981	SORO FISIOLOGICO 0,9% 10 ML SI IV AP	0.0000	0.9600	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	03280	CLOREXIDINA 2 % ST TP ML	0.0000	0.5300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	52392	SONDA DE ASPIRAÇAO TRAQUEAL C/ VALVULA UN	0.0000	0.9400	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	52392	SONDA DE ASPIRAÇAO TRAQUEAL C/ VALVULA UN	0.0000	0.9400	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	09070	ACETILCISTEINA 600MG PO VO SA	0.0000	3.4950	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	00097	ABOCATH N 14 A 22 UN	0.0000	0.0000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	15f461c0ca379f375bd9f8b18fbb101a	ANA	12753753845	NULL	12753753845	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.0000	0.4000	NULL	VALOR APRESENTADO A MAIOR	1705
Glosa Min	2018-10-03 00:00:00.000000	1084117	15f461c0ca379f375bd9f8b18fbb101a	ANA	12753753845	NULL	12753753845	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.0000	0.4000	NULL	VALOR APRESENTADO A MAIOR	1705
Glosa Min	2018-10-03 00:00:00.000000	1084117	15f461c0ca379f375bd9f8b18fbb101a	ANA	12753753845	NULL	12753753845	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1800	NULL	VALOR APRESENTADO A MAIOR	1705
Glosa Min	2018-10-03 00:00:00.000000	1084117	15f461c0ca379f375bd9f8b18fbb101a	ANA	12753753845	NULL	12753753845	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1800	NULL	VALOR APRESENTADO A MAIOR	1705
Glosa Min	2018-10-03 00:00:00.000000	1084117	15f461c0ca379f375bd9f8b18fbb101a	ANA	12753753845	NULL	12753753845	51241	AGULHA 123X45	0.0000	0.7700	NULL	VALOR APRESENTADO A MAIOR	1705
Glosa Min	2018-10-03 00:00:00.000000	1084117	15f461c0ca379f375bd9f8b18fbb101a	ANA	12753753845	NULL	12753753845	00657	CEFAZOLINA 1 GR + DIL. 10 ML PO IM IV FA	0.0000	8.1300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	11700	EQUIPO P/ BOMBA DE INFUSAO ENTERAL / PARENTERAL	0.0000	19.6942	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00124	LUVA CIRURGICA UN	0.0000	1.4500	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4056	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4072	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4072	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4072	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4072	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4072	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4072	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4072	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4072	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4072	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4072	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	COBRANCA DE MEDICAMENTO EM QUANTIDADE INCOMPATIVEL COM A PERMANENCIA	2107
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	01611	CLORETO DE POTASSIO 600 MG CA VO UN	0.0000	0.4870	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	02355	AMOXICILINA 1 G + CLAVULANATO 200 MG + DIL. 10 ML	0.0000	36.4667	NULL	COBRANCA DE MEDICAMENTO EM QUANTIDADE INCOMPATIVEL COM A PERMANENCIA	2107
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	02355	AMOXICILINA 1 G + CLAVULANATO 200 MG + DIL. 10 ML	0.0000	36.4667	NULL	COBRANCA DE MEDICAMENTO EM QUANTIDADE INCOMPATIVEL COM A PERMANENCIA	2107
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00090	SERINGA DESC 20 ML UN	0.0000	0.5367	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00090	SERINGA DESC 20 ML UN	0.0000	0.5367	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	2e6b6f291f2df9beb1fbda6028678909	ANNA	12463693448	NULL	12463693448	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	31d18d6607d9e742c53e748d6a55d740	CARLOS	12557779343	NULL	12557779343	54687	IODOPOVIDONA SD TP ML	0.0000	1.4200	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	31d18d6607d9e742c53e748d6a55d740	CARLOS	12557779343	NULL	12557779343	00657	CEFAZOLINA 1 GR + DIL. 10 ML PO IM IV FA	0.0000	8.1200	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	01002	FUROSEMIDA 10 MG/ML 2 ML SI IM IV AP	0.0000	1.8000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00111	ABOCATH N 14 A 22 UN	0.0000	3.7660	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00124	LUVA CIRURGICA UN	0.0000	1.4478	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00124	LUVA CIRURGICA UN	0.0000	1.4478	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00124	LUVA CIRURGICA UN	0.0000	1.4478	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00124	LUVA CIRURGICA UN	0.0000	1.4478	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00124	LUVA CIRURGICA UN	0.0000	1.4500	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.0000	0.6871	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.0000	0.6871	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.0000	0.6871	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.0000	0.6871	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	35382	COMPRESSAS DE GASES 7.5 X7,5 (11 FIOS ESTERIL) UN	0.0000	0.3000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	35382	COMPRESSAS DE GASES 7.5 X7,5 (11 FIOS ESTERIL) UN	0.0000	0.6000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.0000	0.4000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.0000	0.4000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.0000	0.4000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.0000	0.4000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.0000	0.4000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.0000	0.4000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1776	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	51649	ALCOOL ETILICO 70 % ST TP ML	0.0000	0.0000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	52303	NOREPINEFRINA 2 MG/ML 4 ML SI IV AP	0.0000	47.4800	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	54157	EQUIPO P/ DIETA ENTERAL UN	0.0000	1.7000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00090	SERINGA DESC 20 ML UN	0.0000	0.5375	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00090	SERINGA DESC 20 ML UN	0.0000	0.5375	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00090	SERINGA DESC 20 ML UN	0.0000	0.5375	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00090	SERINGA DESC 20 ML UN	0.0000	0.5400	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1965b0cdebe9017c3397c8641147759	JOSE	12705413746	NULL	12705413746	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.0000	NULL	FALTA PRESCRICAO MEDICA	1709
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1965b0cdebe9017c3397c8641147759	JOSE	12705413746	NULL	12705413746	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1965b0cdebe9017c3397c8641147759	JOSE	12705413746	NULL	12705413746	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1965b0cdebe9017c3397c8641147759	JOSE	12705413746	NULL	12705413746	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.0000	0.6800	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1965b0cdebe9017c3397c8641147759	JOSE	12705413746	NULL	12705413746	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.0000	0.8074	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1965b0cdebe9017c3397c8641147759	JOSE	12705413746	NULL	12705413746	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.0000	0.8074	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1965b0cdebe9017c3397c8641147759	JOSE	12705413746	NULL	12705413746	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.0000	0.8074	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1965b0cdebe9017c3397c8641147759	JOSE	12705413746	NULL	12705413746	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.0000	0.8074	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1965b0cdebe9017c3397c8641147759	JOSE	12705413746	NULL	12705413746	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1775	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1965b0cdebe9017c3397c8641147759	JOSE	12705413746	NULL	12705413746	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1775	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1965b0cdebe9017c3397c8641147759	JOSE	12705413746	NULL	12705413746	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1775	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1965b0cdebe9017c3397c8641147759	JOSE	12705413746	NULL	12705413746	51584	ESPARADRAPO MICROPORE	0.0000	0.3800	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1965b0cdebe9017c3397c8641147759	JOSE	12705413746	NULL	12705413746	51671	REPARIL (ESCINA + DIETILAMONIO) GL TP GR	0.0000	0.0000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1965b0cdebe9017c3397c8641147759	JOSE	12705413746	NULL	12705413746	00090	SERINGA DESC 20 ML UN	0.0000	0.5375	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1965b0cdebe9017c3397c8641147759	JOSE	12705413746	NULL	12705413746	00090	SERINGA DESC 20 ML UN	0.0000	0.5375	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1965b0cdebe9017c3397c8641147759	JOSE	12705413746	NULL	12705413746	00090	SERINGA DESC 20 ML UN	0.0000	0.5375	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1965b0cdebe9017c3397c8641147759	JOSE	12705413746	NULL	12705413746	00090	SERINGA DESC 20 ML UN	0.0000	0.5375	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1965b0cdebe9017c3397c8641147759	JOSE	12705413746	NULL	12705413746	00090	SERINGA DESC 20 ML UN	0.0000	0.5375	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1965b0cdebe9017c3397c8641147759	JOSE	12705413746	NULL	12705413746	00090	SERINGA DESC 20 ML UN	0.0000	0.5375	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	dd6f8d6c53ffe9bfd3aa9590ba500cc8	ILDA	12751932542	NULL	12751932542	00657	CEFAZOLINA 1 GR + DIL. 10 ML PO IM IV FA	0.0000	32.5000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	dd6f8d6c53ffe9bfd3aa9590ba500cc8	ILDA	12751932542	NULL	12751932542	00069	SERINGA DESC 10 ML UN	0.0000	0.6660	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a39fe8b0276da428395df4da4f2b1537	JOSE	12442708440	NULL	12442708440	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a39fe8b0276da428395df4da4f2b1537	JOSE	12442708440	NULL	12442708440	01691	NISTATINA 100.000 UI/ML SU VO ML	0.0000	0.3000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a39fe8b0276da428395df4da4f2b1537	JOSE	12442708440	NULL	12442708440	20691	HIDROCORTISONA 100 MG PO IM IV FA	0.0000	2.8300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a39fe8b0276da428395df4da4f2b1537	JOSE	12442708440	NULL	12442708440	20691	HIDROCORTISONA 100 MG PO IM IV FA	0.0000	2.8300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a39fe8b0276da428395df4da4f2b1537	JOSE	12442708440	NULL	12442708440	20691	HIDROCORTISONA 100 MG PO IM IV FA	0.0000	2.8300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a39fe8b0276da428395df4da4f2b1537	JOSE	12442708440	NULL	12442708440	20691	HIDROCORTISONA 100 MG PO IM IV FA	0.0000	2.8300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a39fe8b0276da428395df4da4f2b1537	JOSE	12442708440	NULL	12442708440	20691	HIDROCORTISONA 100 MG PO IM IV FA	0.0000	2.8300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a39fe8b0276da428395df4da4f2b1537	JOSE	12442708440	NULL	12442708440	20691	HIDROCORTISONA 100 MG PO IM IV FA	0.0000	2.8300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a39fe8b0276da428395df4da4f2b1537	JOSE	12442708440	NULL	12442708440	26981	SORO FISIOLOGICO 0,9% 10 ML SI IV AP	0.0000	0.1400	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a39fe8b0276da428395df4da4f2b1537	JOSE	12442708440	NULL	12442708440	26981	SORO FISIOLOGICO 0,9% 10 ML SI IV AP	0.0000	0.1400	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a39fe8b0276da428395df4da4f2b1537	JOSE	12442708440	NULL	12442708440	26981	SORO FISIOLOGICO 0,9% 10 ML SI IV AP	0.0000	0.1400	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a39fe8b0276da428395df4da4f2b1537	JOSE	12442708440	NULL	12442708440	26981	SORO FISIOLOGICO 0,9% 10 ML SI IV AP	0.0000	0.1400	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a39fe8b0276da428395df4da4f2b1537	JOSE	12442708440	NULL	12442708440	26981	SORO FISIOLOGICO 0,9% 10 ML SI IV AP	0.0000	0.1400	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a39fe8b0276da428395df4da4f2b1537	JOSE	12442708440	NULL	12442708440	29020166	Nebulização Simples com Broncodilatador	0.0000	1.1700	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a39fe8b0276da428395df4da4f2b1537	JOSE	12442708440	NULL	12442708440	29020166	Nebulização Simples com Broncodilatador	0.0000	8.0949	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a39fe8b0276da428395df4da4f2b1537	JOSE	12442708440	NULL	12442708440	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1765	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a39fe8b0276da428395df4da4f2b1537	JOSE	12442708440	NULL	12442708440	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1765	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a39fe8b0276da428395df4da4f2b1537	JOSE	12442708440	NULL	12442708440	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1765	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a39fe8b0276da428395df4da4f2b1537	JOSE	12442708440	NULL	12442708440	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1765	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a39fe8b0276da428395df4da4f2b1537	JOSE	12442708440	NULL	12442708440	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1765	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a39fe8b0276da428395df4da4f2b1537	JOSE	12442708440	NULL	12442708440	51241	AGULHA 123X45	0.0000	0.1900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a39fe8b0276da428395df4da4f2b1537	JOSE	12442708440	NULL	12442708440	51241	AGULHA 123X45	0.0000	0.1900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a39fe8b0276da428395df4da4f2b1537	JOSE	12442708440	NULL	12442708440	51241	AGULHA 123X45	0.0000	0.1900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a39fe8b0276da428395df4da4f2b1537	JOSE	12442708440	NULL	12442708440	51241	AGULHA 123X45	0.0000	0.1900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a39fe8b0276da428395df4da4f2b1537	JOSE	12442708440	NULL	12442708440	51659	FENOTEROL 2 MG/ML 10 ML AE IN DS	0.0000	0.2565	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a39fe8b0276da428395df4da4f2b1537	JOSE	12442708440	NULL	12442708440	00090	SERINGA DESC 20 ML UN	0.0000	0.5373	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a39fe8b0276da428395df4da4f2b1537	JOSE	12442708440	NULL	12442708440	00090	SERINGA DESC 20 ML UN	0.0000	0.5373	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a39fe8b0276da428395df4da4f2b1537	JOSE	12442708440	NULL	12442708440	00097	ABOCATH N 14 A 22 UN	0.0000	3.7700	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	61e4786d45edfdbf19b77fb2c6ce6b9c	REINALDO	12754482747	NULL	12754482747	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	61e4786d45edfdbf19b77fb2c6ce6b9c	REINALDO	12754482747	NULL	12754482747	00172	SORO FISIOLOGICO 0,9% 500 ML SI IV BS	0.0000	4.7300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	61e4786d45edfdbf19b77fb2c6ce6b9c	REINALDO	12754482747	NULL	12754482747	02178	TENOXICAM 20 MG + DIL. 2 ML PO IM IV FA	0.0000	7.1600	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	61e4786d45edfdbf19b77fb2c6ce6b9c	REINALDO	12754482747	NULL	12754482747	30010128	Quimioterapia Sistêmica Inicial no 1o. Dia da Semana (por Ciclo de 7 Dias de Tratamento)	0.0000	0.0000	NULL	COBRANCA DE HONORARIOS EM DUPLICIDADE	2607
Glosa Min	2018-10-03 00:00:00.000000	1084117	61e4786d45edfdbf19b77fb2c6ce6b9c	REINALDO	12754482747	NULL	12754482747	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	61e4786d45edfdbf19b77fb2c6ce6b9c	REINALDO	12754482747	NULL	12754482747	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	61e4786d45edfdbf19b77fb2c6ce6b9c	REINALDO	12754482747	NULL	12754482747	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	VALOR APRESENTADO A MAIOR	1705
Glosa Min	2018-10-03 00:00:00.000000	1084117	61e4786d45edfdbf19b77fb2c6ce6b9c	REINALDO	12754482747	NULL	12754482747	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	61e4786d45edfdbf19b77fb2c6ce6b9c	REINALDO	12754482747	NULL	12754482747	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.0000	0.6900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	61e4786d45edfdbf19b77fb2c6ce6b9c	REINALDO	12754482747	NULL	12754482747	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.0000	0.6900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	61e4786d45edfdbf19b77fb2c6ce6b9c	REINALDO	12754482747	NULL	12754482747	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.0000	0.6900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	61e4786d45edfdbf19b77fb2c6ce6b9c	REINALDO	12754482747	NULL	12754482747	53780	VASELINA LIQUIDA SL OU TP ML	0.0000	0.0200	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	61e4786d45edfdbf19b77fb2c6ce6b9c	REINALDO	12754482747	NULL	12754482747	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	61e4786d45edfdbf19b77fb2c6ce6b9c	REINALDO	12754482747	NULL	12754482747	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	61e4786d45edfdbf19b77fb2c6ce6b9c	REINALDO	12754482747	NULL	12754482747	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	61e4786d45edfdbf19b77fb2c6ce6b9c	REINALDO	12754482747	NULL	12754482747	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4072	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4072	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4072	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4072	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4072	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	00090	SERINGA DESC 20 ML UN	0.0000	0.5371	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	00090	SERINGA DESC 20 ML UN	0.0000	0.5400	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	00090	SERINGA DESC 20 ML UN	0.0000	0.5371	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	00090	SERINGA DESC 20 ML UN	0.0000	0.5371	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	00090	SERINGA DESC 20 ML UN	0.0000	0.5371	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	00090	SERINGA DESC 20 ML UN	0.0000	0.5371	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	00090	SERINGA DESC 20 ML UN	0.0000	0.5371	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	00090	SERINGA DESC 20 ML UN	0.0000	0.5371	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	00091	SERINGA DESC 01 ML (INSULINA) UN	0.0000	0.3000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	081fdadb830fb547e83c43fabdb88372	ELZA	12377335349	NULL	12377335349	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	081fdadb830fb547e83c43fabdb88372	ELZA	12377335349	NULL	12377335349	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	081fdadb830fb547e83c43fabdb88372	ELZA	12377335349	NULL	12377335349	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	081fdadb830fb547e83c43fabdb88372	ELZA	12377335349	NULL	12377335349	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	081fdadb830fb547e83c43fabdb88372	ELZA	12377335349	NULL	12377335349	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	081fdadb830fb547e83c43fabdb88372	ELZA	12377335349	NULL	12377335349	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	EXAME SEM REGISTRO DE EXECUCAO	2703
Glosa Min	2018-10-03 00:00:00.000000	1084117	081fdadb830fb547e83c43fabdb88372	ELZA	12377335349	NULL	12377335349	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1800	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	081fdadb830fb547e83c43fabdb88372	ELZA	12377335349	NULL	12377335349	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1800	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	081fdadb830fb547e83c43fabdb88372	ELZA	12377335349	NULL	12377335349	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1800	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.0000	0.6860	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.0000	0.6860	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.0000	0.6860	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.0000	0.6860	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	51379	SERINGA DESC 05 ML UN	0.0000	0.1900	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	51379	SERINGA DESC 05 ML UN	0.0000	0.1900	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	51379	SERINGA DESC 05 ML UN	0.0000	0.1900	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	51379	SERINGA DESC 05 ML UN	0.0000	0.1900	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	51379	SERINGA DESC 05 ML UN	0.0000	0.1900	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	51379	SERINGA DESC 05 ML UN	0.0000	0.1900	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	345c226bfea274af1372d41b0305a6c8	ALTINO	12720257940	NULL	12720257940	00493	BROMOPRIDA 5 MG/ML 2 ML SI IM IV AP	0.0000	2.7300	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	345c226bfea274af1372d41b0305a6c8	ALTINO	12720257940	NULL	12720257940	00090	SERINGA DESC 20 ML UN	0.0000	0.5364	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	345c226bfea274af1372d41b0305a6c8	ALTINO	12720257940	NULL	12720257940	00090	SERINGA DESC 20 ML UN	0.0000	0.5367	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	345c226bfea274af1372d41b0305a6c8	ALTINO	12720257940	NULL	12720257940	00090	SERINGA DESC 20 ML UN	0.0000	0.5400	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	345c226bfea274af1372d41b0305a6c8	ALTINO	12720257940	NULL	12720257940	00090	SERINGA DESC 20 ML UN	0.0000	0.5367	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	345c226bfea274af1372d41b0305a6c8	ALTINO	12720257940	NULL	12720257940	00090	SERINGA DESC 20 ML UN	0.0000	0.5367	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	dd486d36a88cfef0b44fe652638a0164	DELFINA	12660326244	NULL	12660326244	101001	DIARIA DE ENFERMARIA	0.0000	1386.5900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	dd486d36a88cfef0b44fe652638a0164	DELFINA	12660326244	NULL	12660326244	01062	CATETER OXIGENIO TIPO OCULOS UN	0.0000	1.0000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	dd486d36a88cfef0b44fe652638a0164	DELFINA	12660326244	NULL	12660326244	00124	LUVA CIRURGICA UN	0.0000	1.4500	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	dd486d36a88cfef0b44fe652638a0164	DELFINA	12660326244	NULL	12660326244	00128	LUVA DE PROCEDIMENTO UNIDADE UN	0.0000	0.6700	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	dd486d36a88cfef0b44fe652638a0164	DELFINA	12660326244	NULL	12660326244	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	dd486d36a88cfef0b44fe652638a0164	DELFINA	12660326244	NULL	12660326244	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	dd486d36a88cfef0b44fe652638a0164	DELFINA	12660326244	NULL	12660326244	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	dd486d36a88cfef0b44fe652638a0164	DELFINA	12660326244	NULL	12660326244	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	dd486d36a88cfef0b44fe652638a0164	DELFINA	12660326244	NULL	12660326244	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	dd486d36a88cfef0b44fe652638a0164	DELFINA	12660326244	NULL	12660326244	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	dd486d36a88cfef0b44fe652638a0164	DELFINA	12660326244	NULL	12660326244	00090	SERINGA DESC 20 ML UN	0.0000	0.5400	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	dd486d36a88cfef0b44fe652638a0164	DELFINA	12660326244	NULL	12660326244	00090	SERINGA DESC 20 ML UN	0.0000	0.5400	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	dd486d36a88cfef0b44fe652638a0164	DELFINA	12660326244	NULL	12660326244	00919	ALGODAO HIDROFILO BOLINHA UN	0.0000	0.2600	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	01652	TRAMADOL 50 MG CP VO UN	0.0000	1.9300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	01652	TRAMADOL 50 MG CP VO UN	0.0000	1.9300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.0000	0.6900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.0000	0.6900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.0000	0.6875	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.0000	0.6900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.0000	0.6900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.0000	0.6900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.0000	0.6900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	35382	COMPRESSAS DE GASES 7.5 X7,5 (11 FIOS ESTERIL) UN	0.0000	0.3000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	35382	COMPRESSAS DE GASES 7.5 X7,5 (11 FIOS ESTERIL) UN	0.0000	0.3000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.0000	0.8100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1800	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1800	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1800	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1800	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3fb5c891f31bb9efcb05395066127c52	ALAIDE	12636273441	NULL	12636273441	00487	RANITIDINA 25 MG/ML 2 ML SI IM IV AP	0.0000	0.9300	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3fb5c891f31bb9efcb05395066127c52	ALAIDE	12636273441	NULL	12636273441	00487	RANITIDINA 25 MG/ML 2 ML SI IM IV AP	0.0000	0.9300	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	610c198ec4c064687cf0524f147d3aed	ROBERTO	12748814743	NULL	12748814743	16322	BENZILPENICILINA POTASSICA CRIST. 5.000.000	8.0700	8.0683	0.0017	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	610c198ec4c064687cf0524f147d3aed	ROBERTO	12748814743	NULL	12748814743	16322	BENZILPENICILINA POTASSICA CRIST. 5.000.000	8.0700	8.0683	0.0017	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	610c198ec4c064687cf0524f147d3aed	ROBERTO	12748814743	NULL	12748814743	16322	BENZILPENICILINA POTASSICA CRIST. 5.000.000	8.0700	8.0683	0.0017	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.0800	0.1000	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	53932	ALPRAZOLAM 0,25 MG CP VO UN	0.2600	0.1100	0.1500	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00127	LUVA DE PROCEDIMENTO UNIDADE UN	0.3300	0.1300	0.2000	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00127	LUVA DE PROCEDIMENTO UNIDADE UN	0.3300	0.1300	0.2000	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00127	LUVA DE PROCEDIMENTO UNIDADE UN	0.3300	0.1300	0.2000	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.4000	0.1600	0.2400	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.4000	0.1600	0.2400	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.4000	0.1600	0.2400	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.4000	0.1600	0.2400	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.4000	0.1600	0.2400	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.4000	0.1600	0.2400	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.4000	0.1600	0.2400	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	51708	Dieta Hipercalorica Hiperproteica Sem Fibras 1.5 kcal	52.8500	20.6300	32.2200	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	54175	DIETA SEMI ELEMENTAR 1.0 KCAL/ML EM EN ML	57.6000	22.4900	35.1100	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	19400	CIPROFLOXACINO 2 MG/ML 100 ML SI IV BS	80.1700	31.3000	48.8700	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	19400	CIPROFLOXACINO 2 MG/ML 100 ML SI IV BS	80.1700	31.3000	48.8700	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	07802	PIPERACILINA 4 G + TAZOBACTAM 500 MG PO IV FA	83.4500	32.5900	50.8600	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	07802	PIPERACILINA 4 G + TAZOBACTAM 500 MG PO IV FA	83.4500	32.5900	50.8600	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	16b1e9f62f247f02ad5cac910ee15b4e	BERCHOLINA	12631612848	NULL	12631612848	04073	TRAMADOL 50 MG 1 ML SI IM IV AP	4.1900	4.0000	0.1900	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	16b1e9f62f247f02ad5cac910ee15b4e	BERCHOLINA	12631612848	NULL	12631612848	04073	TRAMADOL 50 MG 1 ML SI IM IV AP	4.1900	4.0000	0.1900	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	16b1e9f62f247f02ad5cac910ee15b4e	BERCHOLINA	12631612848	NULL	12631612848	22421	PIPERACILINA 2 G + TAZOBACTAM 250 MG 30 ML PO IV	55.3400	52.7400	2.6000	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	16b1e9f62f247f02ad5cac910ee15b4e	BERCHOLINA	12631612848	NULL	12631612848	22421	PIPERACILINA 2 G + TAZOBACTAM 250 MG 30 ML PO IV	55.3400	52.7400	2.6000	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	16b1e9f62f247f02ad5cac910ee15b4e	BERCHOLINA	12631612848	NULL	12631612848	22421	PIPERACILINA 2 G + TAZOBACTAM 250 MG 30 ML PO IV	55.3400	52.7400	2.6000	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	16b1e9f62f247f02ad5cac910ee15b4e	BERCHOLINA	12631612848	NULL	12631612848	22421	PIPERACILINA 2 G + TAZOBACTAM 250 MG 30 ML PO IV	55.3400	52.7400	2.6000	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	16b1e9f62f247f02ad5cac910ee15b4e	BERCHOLINA	12631612848	NULL	12631612848	00171	SORO FISIOLOGICO 0,9% 250 ML SI IV BS	3.9400	3.7600	0.1800	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	16b1e9f62f247f02ad5cac910ee15b4e	BERCHOLINA	12631612848	NULL	12631612848	00090	SERINGA DESC 20 ML UN	0.5400	0.5200	0.0200	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	16b1e9f62f247f02ad5cac910ee15b4e	BERCHOLINA	12631612848	NULL	12631612848	00090	SERINGA DESC 20 ML UN	0.5400	0.5200	0.0200	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	16b1e9f62f247f02ad5cac910ee15b4e	BERCHOLINA	12631612848	NULL	12631612848	00090	SERINGA DESC 20 ML UN	0.5400	0.5200	0.0200	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	16b1e9f62f247f02ad5cac910ee15b4e	BERCHOLINA	12631612848	NULL	12631612848	00090	SERINGA DESC 20 ML UN	0.5400	0.5200	0.0200	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	16b1e9f62f247f02ad5cac910ee15b4e	BERCHOLINA	12631612848	NULL	12631612848	36432	HIDROCLOROTIAZIDA 25 MG CP VO UN	0.2400	0.2300	0.0100	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	16b1e9f62f247f02ad5cac910ee15b4e	BERCHOLINA	12631612848	NULL	12631612848	33219	LUVA DE PROCEDIMENTO UNIDADE UN	0.8370	1.0018	-0.3318	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	16b1e9f62f247f02ad5cac910ee15b4e	BERCHOLINA	12631612848	NULL	12631612848	00590	AGULHA DESC 30 X 7 - 40X12 UN	4.3100	0.7126	3.5974	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	16b1e9f62f247f02ad5cac910ee15b4e	BERCHOLINA	12631612848	NULL	12631612848	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4081	0.0019	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	16b1e9f62f247f02ad5cac910ee15b4e	BERCHOLINA	12631612848	NULL	12631612848	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4081	0.0019	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	16b1e9f62f247f02ad5cac910ee15b4e	BERCHOLINA	12631612848	NULL	12631612848	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4081	0.0019	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	16b1e9f62f247f02ad5cac910ee15b4e	BERCHOLINA	12631612848	NULL	12631612848	33219	LUVA DE PROCEDIMENTO UNIDADE UN	1.0000	1.1688	-0.1688	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	32050054	RX Tórax: P. A. - Lat	20.2100	7.8900	12.3200	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	51673	ALGINATO DE CALCIO EM HIDROGEL GL TP GR	17.2500	6.7300	10.5200	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	32050038	RX Tórax: P. A.	15.7500	6.1500	9.6000	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00613	CLINDAMICINA 600 MG 4 ML SI IM IV AP	13.0800	5.1000	7.9800	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00613	CLINDAMICINA 600 MG 4 ML SI IM IV AP	13.0800	5.1000	7.9800	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00613	CLINDAMICINA 600 MG 4 ML SI IM IV AP	13.0800	5.1000	7.9800	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	51620	Modulo Em Pó De Fibras Solúveis	7.3100	2.8500	4.4600	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00404	LACTULOSE 667 MG/ML XP VO ML	6.4300	2.5100	3.9200	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	53144	TRAMAL	5.9900	2.3300	3.6600	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	53144	TRAMAL	5.9900	2.3300	3.6600	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00172	SORO FISIOLOGICO 0,9% 500 ML SI IV BS	4.7300	1.8400	2.8900	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	51673	ALGINATO DE CALCIO EM HIDROGEL GL TP GR	3.4500	1.3400	2.1100	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00493	BROMOPRIDA 5 MG/ML 2 ML SI IM IV AP	2.7300	1.0600	1.6700	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00493	BROMOPRIDA 5 MG/ML 2 ML SI IM IV AP	2.7300	1.0600	1.6700	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00493	BROMOPRIDA 5 MG/ML 2 ML SI IM IV AP	2.7300	1.0600	1.6700	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00128	LUVA DE PROCEDIMENTO UNIDADE UN	1.0000	0.3900	0.6100	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.6900	0.2700	0.4200	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.6900	0.2700	0.4200	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.6900	0.2700	0.4200	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.6900	0.2700	0.4200	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00090	SERINGA DESC 20 ML UN	0.5400	0.2200	0.3200	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00090	SERINGA DESC 20 ML UN	0.5400	0.2200	0.3200	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00090	SERINGA DESC 20 ML UN	0.5400	0.2200	0.3200	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00090	SERINGA DESC 20 ML UN	0.5400	0.2200	0.3200	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	3fb5c891f31bb9efcb05395066127c52	ALAIDE	12636273441	NULL	12636273441	14250	PARACETAMOL 750 MG CP VO UN	0.0000	0.0000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	f3ad474c8c562757c4d1a959ff0961c4	DJALMA	12718763240	NULL	12718763240	00090	SERINGA DESC 20 ML UN	0.0000	0.5400	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	f3ad474c8c562757c4d1a959ff0961c4	DJALMA	12718763240	NULL	12718763240	00090	SERINGA DESC 20 ML UN	0.0000	0.5400	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	f3ad474c8c562757c4d1a959ff0961c4	DJALMA	12718763240	NULL	12718763240	00090	SERINGA DESC 20 ML UN	0.0000	0.5400	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	f3ad474c8c562757c4d1a959ff0961c4	DJALMA	12718763240	NULL	12718763240	51584	ESPARADRAPO MICROPORE	0.0000	0.7700	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	f3ad474c8c562757c4d1a959ff0961c4	DJALMA	12718763240	NULL	12718763240	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1800	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	f3ad474c8c562757c4d1a959ff0961c4	DJALMA	12718763240	NULL	12718763240	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1800	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	f3ad474c8c562757c4d1a959ff0961c4	DJALMA	12718763240	NULL	12718763240	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	f3ad474c8c562757c4d1a959ff0961c4	DJALMA	12718763240	NULL	12718763240	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	f3ad474c8c562757c4d1a959ff0961c4	DJALMA	12718763240	NULL	12718763240	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	f3ad474c8c562757c4d1a959ff0961c4	DJALMA	12718763240	NULL	12718763240	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	f3ad474c8c562757c4d1a959ff0961c4	DJALMA	12718763240	NULL	12718763240	102001	DIARIA DE APARTAMENTO	0.0000	288.8900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	00919	ALGODAO HIDROFILO BOLINHA UN	0.0000	0.2600	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	00090	SERINGA DESC 20 ML UN	0.0000	0.5400	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	00090	SERINGA DESC 20 ML UN	0.0000	0.5400	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	00090	SERINGA DESC 20 ML UN	0.0000	0.5400	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	00090	SERINGA DESC 20 ML UN	0.0000	0.5400	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	00090	SERINGA DESC 20 ML UN	0.0000	0.5400	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	51649	ALCOOL ETILICO 70 % ST TP ML	0.0000	0.0300	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4068	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	00128	LUVA DE PROCEDIMENTO UNIDADE UN	0.0000	1.0000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	00128	LUVA DE PROCEDIMENTO UNIDADE UN	0.0000	1.0000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	00128	LUVA DE PROCEDIMENTO UNIDADE UN	0.0000	0.6700	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	00128	LUVA DE PROCEDIMENTO UNIDADE UN	0.0000	0.6700	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	11325	EQUIPO MACRO-GOTAS FLEXIVEL C/ INJETOR LATERAL UN	0.0000	1.5900	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	102001	DIARIA DE APARTAMENTO	0.0000	288.8900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	102001	DIARIA DE APARTAMENTO	0.0000	288.8900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	102001	DIARIA DE APARTAMENTO	0.0000	288.8900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	dd486d36a88cfef0b44fe652638a0164	DELFINA	12660326244	NULL	12660326244	06400	CARVEDILOL 3,125 MG CP VO UN	0.0000	0.7300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	dd486d36a88cfef0b44fe652638a0164	DELFINA	12660326244	NULL	12660326244	54687	IODOPOVIDONA SD TP ML	0.0000	0.6000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	dd486d36a88cfef0b44fe652638a0164	DELFINA	12660326244	NULL	12660326244	51588	ESPARADRAPO MICROPORE 50 X 10 CM CM	0.0000	0.7700	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	dd486d36a88cfef0b44fe652638a0164	DELFINA	12660326244	NULL	12660326244	51588	ESPARADRAPO MICROPORE 50 X 10 CM CM	0.0000	0.7700	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	dd486d36a88cfef0b44fe652638a0164	DELFINA	12660326244	NULL	12660326244	51497	ESPIRONOLACTONA 50 MG + HIDROCLOROTIAZIDA 50 MG	0.0000	0.9800	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	dd486d36a88cfef0b44fe652638a0164	DELFINA	12660326244	NULL	12660326244	51497	ESPIRONOLACTONA 50 MG + HIDROCLOROTIAZIDA 50 MG	0.0000	0.9800	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	dd486d36a88cfef0b44fe652638a0164	DELFINA	12660326244	NULL	12660326244	51497	ESPIRONOLACTONA 50 MG + HIDROCLOROTIAZIDA 50 MG	0.0000	0.9800	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	dd486d36a88cfef0b44fe652638a0164	DELFINA	12660326244	NULL	12660326244	51379	SERINGA DESC 05 ML UN	0.0000	0.1900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	dd486d36a88cfef0b44fe652638a0164	DELFINA	12660326244	NULL	12660326244	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.0000	0.8100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	dd486d36a88cfef0b44fe652638a0164	DELFINA	12660326244	NULL	12660326244	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.0000	0.8100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	dd486d36a88cfef0b44fe652638a0164	DELFINA	12660326244	NULL	12660326244	00487	RANITIDINA 25 MG/ML 2 ML SI IM IV AP	0.0000	0.9300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	dd486d36a88cfef0b44fe652638a0164	DELFINA	12660326244	NULL	12660326244	00487	RANITIDINA 25 MG/ML 2 ML SI IM IV AP	0.0000	0.9300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00817	ALGODAO HIDROFILO BOLINHA UN	0.2600	0.1300	0.1300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12579183644	NULL	12579183644	00426	AGUA BIDESTILADA 10 ML SI IV IM AP	0.4000	0.0000	0.4000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12579183644	NULL	12579183644	00817	ALGODAO HIDROFILO BOLINHA UN	0.5100	0.2600	0.2500	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12579183644	NULL	12579183644	00485	AGUA BIDESTILADA 500 ML SI IM IV BS	6.4300	0.0000	6.4300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12579183644	NULL	12579183644	28959	DERSANI LC TP ML	19.4000	14.5500	4.8500	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12579183644	NULL	12579183644	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.3500	0.0000	0.3500	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12579183644	NULL	12579183644	37761	ALCOOL ETILICO 70 % ST TP ML	0.0600	0.0300	0.0300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12579183644	NULL	12579183644	00485	AGUA BIDESTILADA 500 ML SI IM IV BS	6.4300	0.0000	6.4300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12579183644	NULL	12579183644	37761	ALCOOL ETILICO 70 % ST TP ML	0.0600	0.0300	0.0300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12579183644	NULL	12579183644	00817	ALGODAO HIDROFILO BOLINHA UN	0.5100	0.2600	0.2500	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	d17b3c5ae418d82694895a326dee545a	ODILIA	12670516743	NULL	12670516743	37761	ALCOOL ETILICO 70 % ST TP ML	0.0300	0.0200	0.0100	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	d17b3c5ae418d82694895a326dee545a	ODILIA	12670516743	NULL	12670516743	37761	ALCOOL ETILICO 70 % ST TP ML	0.0600	0.0200	0.0400	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	d17b3c5ae418d82694895a326dee545a	ODILIA	12670516743	NULL	12670516743	37761	ALCOOL ETILICO 70 % ST TP ML	0.0600	0.0200	0.0400	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	d17b3c5ae418d82694895a326dee545a	ODILIA	12670516743	NULL	12670516743	33219	LUVA DE PROCEDIMENTO UNIDADE UN	1.0000	0.6700	0.3300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	d17b3c5ae418d82694895a326dee545a	ODILIA	12670516743	NULL	12670516743	37761	ALCOOL ETILICO 70 % ST TP ML	0.0300	0.0200	0.0100	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	d17b3c5ae418d82694895a326dee545a	ODILIA	12670516743	NULL	12670516743	00817	ALGODAO HIDROFILO BOLINHA UN	0.2600	0.1300	0.1300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	20cbe2e07b1dcd2b6af609a50df7ae80	LUCELENA	12690767849	NULL	12690767849	37761	ALCOOL ETILICO 70 % ST TP ML	0.0300	0.0200	0.0100	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	20cbe2e07b1dcd2b6af609a50df7ae80	LUCELENA	12690767849	NULL	12690767849	00817	ALGODAO HIDROFILO BOLINHA UN	0.2600	0.1300	0.1300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	20cbe2e07b1dcd2b6af609a50df7ae80	LUCELENA	12690767849	NULL	12690767849	37761	ALCOOL ETILICO 70 % ST TP ML	0.0600	0.0300	0.0300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	20cbe2e07b1dcd2b6af609a50df7ae80	LUCELENA	12690767849	NULL	12690767849	37761	ALCOOL ETILICO 70 % ST TP ML	0.0600	0.0200	0.0400	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	11193	CLOREXIDINA 2 % ST TP ML	1.6000	0.2700	1.3300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	02720	BOLSA COLETORA (SISTEMA ABERTO) UN	1.2800	0.9600	0.3200	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	37761	ALCOOL ETILICO 70 % ST TP ML	0.0300	0.0200	0.0100	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00817	ALGODAO HIDROFILO BOLINHA UN	0.2600	0.1300	0.1300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	33219	LUVA DE PROCEDIMENTO UNIDADE UN	1.0000	0.6700	0.3300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	32891	EQUIPO POLIFIX 2ş VIAS UN	5.1000	0.0000	5.1000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00817	ALGODAO HIDROFILO BOLINHA UN	0.5100	0.2600	0.2500	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00485	AGUA BIDESTILADA 500 ML SI IM IV BS	6.4300	0.0000	6.4300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00817	ALGODAO HIDROFILO BOLINHA UN	0.5100	0.2600	0.2500	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	08648	ESPARADRAPO 10 X 4.5 CM CM	0.4000	0.0000	0.4000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00485	AGUA BIDESTILADA 500 ML SI IM IV BS	6.4300	0.0000	6.4300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	08648	ESPARADRAPO 10 X 4.5 CM CM	0.4000	0.2000	0.2000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	02720	BOLSA COLETORA (SISTEMA ABERTO) UN	1.2800	0.6400	0.6400	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	02720	BOLSA COLETORA (SISTEMA ABERTO) UN	1.2800	0.6400	0.6400	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.0000	0.1000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00485	AGUA BIDESTILADA 500 ML SI IM IV BS	6.4300	0.0000	6.4300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	37761	ALCOOL ETILICO 70 % ST TP ML	0.0600	0.0300	0.0300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.0000	0.1000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	37761	ALCOOL ETILICO 70 % ST TP ML	0.0600	0.0300	0.0300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00817	ALGODAO HIDROFILO BOLINHA UN	0.5100	0.2600	0.2500	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	752c651cb4fd049e19c685f87fbe8bdc	EDUARDO	12765990646	NULL	12765990646	37761	ALCOOL ETILICO 70 % ST TP ML	0.0300	0.0200	0.0100	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	752c651cb4fd049e19c685f87fbe8bdc	EDUARDO	12765990646	NULL	12765990646	00817	ALGODAO HIDROFILO BOLINHA UN	0.2600	0.1300	0.1300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	752c651cb4fd049e19c685f87fbe8bdc	EDUARDO	12765990646	NULL	12765990646	00817	ALGODAO HIDROFILO BOLINHA UN	0.2600	0.1300	0.1300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	752c651cb4fd049e19c685f87fbe8bdc	EDUARDO	12765990646	NULL	12765990646	37761	ALCOOL ETILICO 70 % ST TP ML	0.0600	0.0200	0.0400	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	752c651cb4fd049e19c685f87fbe8bdc	EDUARDO	12765990646	NULL	12765990646	37761	ALCOOL ETILICO 70 % ST TP ML	0.0300	0.0200	0.0100	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	08648	ESPARADRAPO 10 X 4.5 CM CM	0.4000	0.2000	0.2000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00817	ALGODAO HIDROFILO BOLINHA UN	0.2600	0.1300	0.1300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00817	ALGODAO HIDROFILO BOLINHA UN	0.2600	0.1300	0.1300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	02461	FENOTEROL 2 MG/ML 10 ML AE IN DS	2.5500	0.0000	2.5500	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	05975	COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER	0.3000	0.0000	0.3000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	345c226bfea274af1372d41b0305a6c8	ALTINO	12720257940	NULL	12720257940	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.1000	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	345c226bfea274af1372d41b0305a6c8	ALTINO	12720257940	NULL	12720257940	07269	DIPIRONA 500 MG/ML 2 ML SI IV IM AP	0.6900	0.6860	0.0040	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	345c226bfea274af1372d41b0305a6c8	ALTINO	12720257940	NULL	12720257940	07269	DIPIRONA 500 MG/ML 2 ML SI IV IM AP	0.6900	0.6860	0.0040	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	0405a686318e3fc262f105ed4be24d95	CARMELITA	12687161644	NULL	12687161644	08435	EQUIPO P/ BOMBA DE INFUSAO ENTERAL / PARENT	20.2800	20.2700	0.0000	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	0405a686318e3fc262f105ed4be24d95	CARMELITA	12687161644	NULL	12687161644	07269	DIPIRONA 500 MG/ML 2 ML SI IV IM AP	0.6900	0.6870	0.0030	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	ea6abb4182a48f0934f3e9eb5affa056	DILVA	12697455440	NULL	12697455440	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1750	0.0050	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	500e4b8f04552b423f9db8f81073659f	FIDELIS	12763450340	NULL	12763450340	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1760	0.0040	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	500e4b8f04552b423f9db8f81073659f	FIDELIS	12763450340	NULL	12763450340	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1760	0.0040	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	27600	ONDANSETRONA 2 MG/ML 4 ML SI IM IV AP	13.5300	0.0000	13.5300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1900	0.1850	0.0050	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	27600	ONDANSETRONA 2 MG/ML 4 ML SI IM IV AP	13.5300	0.0000	13.5300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	27600	ONDANSETRONA 2 MG/ML 4 ML SI IM IV AP	13.5300	0.0000	13.5300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	27600	ONDANSETRONA 2 MG/ML 4 ML SI IM IV AP	13.5300	0.0000	13.5300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	27600	ONDANSETRONA 2 MG/ML 4 ML SI IM IV AP	13.5300	0.0000	13.5300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	11193	CLOREXIDINA 2 % ST TP ML	0.5300	0.0000	0.5300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	27600	ONDANSETRONA 2 MG/ML 4 ML SI IM IV AP	13.5300	0.0000	13.5300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	08664	ESPARADRAPO MICROPORE 50 X 10 CM CM	0.2600	0.2562	0.0038	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	08664	ESPARADRAPO MICROPORE 50 X 10 CM CM	0.2600	0.2561	0.0039	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	00817	ALGODAO HIDROFILO BOLINHA UN	0.5100	0.2600	0.2500	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	08648	ESPARADRAPO 10 X 4.5 CM CM	0.4000	0.0000	0.4000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	00817	ALGODAO HIDROFILO BOLINHA UN	0.5100	0.2600	0.2500	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	02720	BOLSA COLETORA (SISTEMA ABERTO) UN	1.2800	0.9600	0.3200	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	37761	ALCOOL ETILICO 70 % ST TP ML	0.0600	0.0000	0.0600	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	32190	CLORETO DE POTASSIO 10% 10 ML SI IV AP	1.1900	0.0000	1.1900	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	00817	ALGODAO HIDROFILO BOLINHA UN	0.5100	0.2600	0.2500	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	02720	BOLSA COLETORA (SISTEMA ABERTO) UN	1.2800	0.9600	0.3200	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	31d18d6607d9e742c53e748d6a55d740	CARLOS	12557779343	NULL	12557779343	11193	CLOREXIDINA 2 % ST TP ML	2.6600	1.8600	0.8000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	31d18d6607d9e742c53e748d6a55d740	CARLOS	12557779343	NULL	12557779343	27308	FIO MONOCRYL 5-0 C /AGULHA 1,65 45CM Y844G	44.2600	0.0000	44.2600	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	33219	LUVA DE PROCEDIMENTO UNIDADE UN	1.0000	0.6700	0.3300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3fb5c891f31bb9efcb05395066127c52	ALAIDE	12636273441	NULL	12636273441	33219	LUVA DE PROCEDIMENTO UNIDADE UN	1.6700	0.5000	1.1700	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	9ffbbf7340bbd65e9e3baa9406d027f3	MARCO	12261811645	NULL	12261811645	00817	ALGODAO HIDROFILO BOLINHA UN	0.2600	0.1300	0.1300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	9ffbbf7340bbd65e9e3baa9406d027f3	MARCO	12261811645	NULL	12261811645	37761	ALCOOL ETILICO 70 % ST TP ML	0.0300	0.0200	0.0100	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	9ffbbf7340bbd65e9e3baa9406d027f3	MARCO	12261811645	NULL	12261811645	00817	ALGODAO HIDROFILO BOLINHA UN	0.2600	0.1300	0.1300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	9ffbbf7340bbd65e9e3baa9406d027f3	MARCO	12261811645	NULL	12261811645	30376	BROMETO DE IPRATROPIO 0,25MG/ML SL IN GT	1.6000	0.0000	1.6000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	9ffbbf7340bbd65e9e3baa9406d027f3	MARCO	12261811645	NULL	12261811645	02461	FENOTEROL 2 MG/ML 10 ML AE IN DS	1.5300	0.0000	1.5300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	9ffbbf7340bbd65e9e3baa9406d027f3	MARCO	12261811645	NULL	12261811645	30376	BROMETO DE IPRATROPIO 0,25MG/ML SL IN GT	1.2000	0.0000	1.2000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	5f044434edae42d3d17c4392018c7824	DINORA	12673932742	NULL	12673932742	07269	DIPIRONA 500 MG/ML 2 ML SI IV IM AP	0.6900	0.0000	0.6900	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	5f044434edae42d3d17c4392018c7824	DINORA	12673932742	NULL	12673932742	19151	SERINGA DESC 10 ML UN	0.3300	0.0000	0.3300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	5f044434edae42d3d17c4392018c7824	DINORA	12673932742	NULL	12673932742	33219	LUVA DE PROCEDIMENTO UNIDADE UN	1.6700	0.0000	1.6700	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	d4089ccef13567fd45b16fb0b60685fa	VERA	12656425943	NULL	12656425943	33219	LUVA DE PROCEDIMENTO UNIDADE UN	0.6700	0.0000	0.6700	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	11134	HEPARINA 5000 UI/ML 5 ML SI IV SC ML	14.4000	2.8800	11.5200	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	00817	ALGODAO HIDROFILO BOLINHA UN	0.5100	0.2600	0.2500	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	20613	SORO GLICOSADO 5% 250 ML SI IV BS	10.1900	0.0000	10.1900	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	20206	SONDA RETAL Nş 20 UN	0.8300	0.0000	0.8300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	cd2840524be5a3f1d0939f241e24f32b	MARIA	12705908340	NULL	12705908340	37761	ALCOOL ETILICO 70 % ST TP ML	0.0300	0.0200	0.0100	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	cd2840524be5a3f1d0939f241e24f32b	MARIA	12705908340	NULL	12705908340	37761	ALCOOL ETILICO 70 % ST TP ML	0.0300	0.0200	0.0100	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	cd2840524be5a3f1d0939f241e24f32b	MARIA	12705908340	NULL	12705908340	00817	ALGODAO HIDROFILO BOLINHA UN	0.2600	0.1300	0.1300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	cd2840524be5a3f1d0939f241e24f32b	MARIA	12705908340	NULL	12705908340	32891	EQUIPO POLIFIX 2ş VIAS UN	5.1000	0.0000	5.1000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12603877940	NULL	12603877940	37761	ALCOOL ETILICO 70 % ST TP ML	0.0300	0.0200	0.0100	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12603877940	NULL	12603877940	55018	ALGINATO DE CALCIO EM HIDROGEL GL TP GR	20.7000	13.8000	6.9000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12603877940	NULL	12603877940	33219	LUVA DE PROCEDIMENTO UNIDADE UN	1.3300	0.6700	0.6600	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12603877940	NULL	12603877940	00426	AGUA BIDESTILADA 10 ML SI IV IM AP	2.0200	0.8100	1.2100	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12603877940	NULL	12603877940	33219	LUVA DE PROCEDIMENTO UNIDADE UN	2.3300	0.6700	1.6600	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12603877940	NULL	12603877940	55018	ALGINATO DE CALCIO EM HIDROGEL GL TP GR	20.7000	13.8000	6.9000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12603877940	NULL	12603877940	11193	CLOREXIDINA 2 % ST TP ML	1.3300	0.2700	1.0600	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12603877940	NULL	12603877940	00817	ALGODAO HIDROFILO BOLINHA UN	0.2600	0.1300	0.1300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12603877940	NULL	12603877940	33227	LUVA CIRURGICA PAR UN	8.6900	5.7900	2.9000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12603877940	NULL	12603877940	00817	ALGODAO HIDROFILO BOLINHA UN	0.2600	0.1300	0.1300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12603877940	NULL	12603877940	00540	AGULHA DESC 13 X 45 UN	0.7700	0.5800	0.1900	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12603877940	NULL	12603877940	37761	ALCOOL ETILICO 70 % ST TP ML	0.0300	0.0200	0.0100	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12603877940	NULL	12603877940	33219	LUVA DE PROCEDIMENTO UNIDADE UN	3.0000	0.6700	2.3300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	37761	ALCOOL ETILICO 70 % ST TP ML	0.0300	0.0200	0.0100	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	37761	ALCOOL ETILICO 70 % ST TP ML	0.0300	0.0200	0.0100	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	02461	FENOTEROL 2 MG/ML 10 ML AE IN DS	1.7900	0.0000	1.7900	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	5f044434edae42d3d17c4392018c7824	DINORA	12673932742	NULL	12673932742	101002	MEIA DIARIA DE ENFERMARIA	0.0000	0.0000	NULL	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	4ff3856efb5e71b547222c677fd1e9f1	DIVINO	12652092848	NULL	12652092848	29020166	NEBULIZACAO SIMPLES COM BRONCODILAT	0.0000	1.1700	NULL	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	4ff3856efb5e71b547222c677fd1e9f1	DIVINO	12652092848	NULL	12652092848	25040014	ASSISTENCIA FISIATRICA RESPIRATORIA	0.0000	5.0300	NULL	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	818a6f2e549cc6a60aa20f9d0595eec9	ANTONIO	12565134343	NULL	12565134343	19160	SERINGA DESC 20 ML UN	0.5400	0.5371	0.0029	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	a050ed50115d2a6dd0b15b99b39063da	ARI	12676101147	NULL	12676101147	20672	SORO RINGER SIMPLES 500 ML SI IV BS	5.9400	5.9300	0.0000	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	a050ed50115d2a6dd0b15b99b39063da	ARI	12676101147	NULL	12676101147	00426	AGUA BIDESTILADA 10 ML SI IV IM AP	0.8100	0.8000	0.0000	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	a050ed50115d2a6dd0b15b99b39063da	ARI	12676101147	NULL	12676101147	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1750	0.0050	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	a050ed50115d2a6dd0b15b99b39063da	ARI	12676101147	NULL	12676101147	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1750	0.0050	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	a050ed50115d2a6dd0b15b99b39063da	ARI	12676101147	NULL	12676101147	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1750	0.0050	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	a050ed50115d2a6dd0b15b99b39063da	ARI	12676101147	NULL	12676101147	13404	OMEPRAZOL 40 MG + DIL. 10 ML PO IV FA	19.5800	19.5750	0.0050	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	a050ed50115d2a6dd0b15b99b39063da	ARI	12676101147	NULL	12676101147	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4067	0.0033	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	edffb7fef608512400078fdf75991573	CARLA	12728631049	NULL	12728631049	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4000	0.0000	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	39df67956a358bf1eab89803158d25dd	HELENA	12655863342	NULL	12655863342	27480	CLARITROMICINA 500 MG 30 ML PO IV FA	117.1100	117.1050	0.0050	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	39df67956a358bf1eab89803158d25dd	HELENA	12655863342	NULL	12655863342	27480	CLARITROMICINA 500 MG 30 ML PO IV FA	117.1100	117.1050	0.0050	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	cb57fc8e673b7c8bc339e1fe25d70cd5	HELIO	12661165148	NULL	12661165148	07269	DIPIRONA 500 MG/ML 2 ML SI IV IM AP	0.6900	0.6866	0.0034	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	a795ed48a125f20b79858b662b4e4e97	JOACIL	12711488840	NULL	12711488840	07269	DIPIRONA 500 MG/ML 2 ML SI IV IM AP	0.6900	0.6800	0.0000	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	4668d2494ed6c4b2d18be299efcb26a2	JOAO	12469689344	NULL	12469689344	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	6.8200	6.8100	0.0000	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	4668d2494ed6c4b2d18be299efcb26a2	JOAO	12469689344	NULL	12469689344	17817	PROLOPA (LEVODOPA 200 MG + BENSERAZIDA 50 M	2.1200	2.1150	0.0050	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	a39fe8b0276da428395df4da4f2b1537	JOSE	12442708440	NULL	12442708440	49824	NISTATINA 100.000 UI SU VO ML	0.3000	0.2950	0.0050	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	01081195	6cc865b10b9b19e72ae4fa1d739f24ec	LAURITA	12743093016	NULL	12743093016	00010014	CONSULTA EM CONSULTORIO MEDICO	0.0000	35.0000	NULL	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	20cbe2e07b1dcd2b6af609a50df7ae80	LUCELENA	12690767849	NULL	12690767849	29020166	NEBULIZACAO SIMPLES COM BRONCODILAT	0.0000	1.1700	NULL	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	db30f3ff84b452c3d28d4f388c6e9976	SIRLEY	12660334845	NULL	12660334845	25040014	ASSISTENCIA FISIATRICA RESPIRATORIA	0.0000	60.3400	NULL	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	6799aa3de305405ab065aad5b599765c	VANIR	12700232345	NULL	12700232345	29020166	NEBULIZACAO SIMPLES COM BRONCODILAT	0.0000	12.8800	NULL	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	de1a8276d878171456d7fc8f6dcd2457	ABEL	12764206443	NULL	12764206443	07269	DIPIRONA 500 MG/ML 2 ML SI IV IM AP	0.6900	0.6860	0.0040	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	de1a8276d878171456d7fc8f6dcd2457	ABEL	12764206443	NULL	12764206443	07269	DIPIRONA 500 MG/ML 2 ML SI IV IM AP	0.6900	0.6860	0.0040	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	eecb3d883747b059c3fe231c34567476	AFFRIDES	12693180144	NULL	12693180144	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1770	0.0030	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	eecb3d883747b059c3fe231c34567476	AFFRIDES	12693180144	NULL	12693180144	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1770	0.0030	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	eecb3d883747b059c3fe231c34567476	AFFRIDES	12693180144	NULL	12693180144	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1770	0.0030	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	eecb3d883747b059c3fe231c34567476	AFFRIDES	12693180144	NULL	12693180144	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1770	0.0030	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	eecb3d883747b059c3fe231c34567476	AFFRIDES	12693180144	NULL	12693180144	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1770	0.0030	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	eecb3d883747b059c3fe231c34567476	AFFRIDES	12693180144	NULL	12693180144	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1770	0.0030	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	eecb3d883747b059c3fe231c34567476	AFFRIDES	12693180144	NULL	12693180144	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1770	0.0030	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	eecb3d883747b059c3fe231c34567476	AFFRIDES	12693180144	NULL	12693180144	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1770	0.0030	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	eecb3d883747b059c3fe231c34567476	AFFRIDES	12693180144	NULL	12693180144	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1770	0.0030	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	eecb3d883747b059c3fe231c34567476	AFFRIDES	12693180144	NULL	12693180144	00426	AGUA BIDESTILADA 10 ML SI IV IM AP	0.8100	0.8072	0.0028	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	eecb3d883747b059c3fe231c34567476	AFFRIDES	12693180144	NULL	12693180144	00426	AGUA BIDESTILADA 10 ML SI IV IM AP	0.8100	0.8072	0.0028	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	eecb3d883747b059c3fe231c34567476	AFFRIDES	12693180144	NULL	12693180144	00426	AGUA BIDESTILADA 10 ML SI IV IM AP	0.8100	0.8072	0.0028	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	eecb3d883747b059c3fe231c34567476	AFFRIDES	12693180144	NULL	12693180144	00426	AGUA BIDESTILADA 10 ML SI IV IM AP	0.8100	0.8072	0.0028	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	eecb3d883747b059c3fe231c34567476	AFFRIDES	12693180144	NULL	12693180144	00426	AGUA BIDESTILADA 10 ML SI IV IM AP	0.8100	0.8072	0.0028	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	eecb3d883747b059c3fe231c34567476	AFFRIDES	12693180144	NULL	12693180144	09733	ACETILCISTEINA 600MG PO VO SA	3.5000	3.4955	0.0045	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	eecb3d883747b059c3fe231c34567476	AFFRIDES	12693180144	NULL	12693180144	09733	ACETILCISTEINA 600MG PO VO SA	3.5000	3.4955	0.0045	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	eecb3d883747b059c3fe231c34567476	AFFRIDES	12693180144	NULL	12693180144	09733	ACETILCISTEINA 600MG PO VO SA	3.5000	3.4955	0.0045	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	eecb3d883747b059c3fe231c34567476	AFFRIDES	12693180144	NULL	12693180144	09733	ACETILCISTEINA 600MG PO VO SA	3.5000	3.4955	0.0045	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	eecb3d883747b059c3fe231c34567476	AFFRIDES	12693180144	NULL	12693180144	09733	ACETILCISTEINA 600MG PO VO SA	3.5000	3.4955	0.0045	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	eecb3d883747b059c3fe231c34567476	AFFRIDES	12693180144	NULL	12693180144	09733	ACETILCISTEINA 600MG PO VO SA	3.5000	3.4955	0.0045	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	eecb3d883747b059c3fe231c34567476	AFFRIDES	12693180144	NULL	12693180144	09733	ACETILCISTEINA 600MG PO VO SA	3.5000	3.4955	0.0045	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	08664	ESPARADRAPO MICROPORE 50 X 10 CM CM	0.2600	0.2561	0.0039	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	08664	ESPARADRAPO MICROPORE 50 X 10 CM CM	0.7700	0.7682	0.0018	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	08664	ESPARADRAPO MICROPORE 50 X 10 CM CM	0.7700	0.7682	0.0018	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	08664	ESPARADRAPO MICROPORE 50 X 10 CM CM	0.7700	0.7682	0.0018	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	37761	ALCOOL ETILICO 70 % ST TP ML	0.0200	0.0150	0.0050	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	20672	SORO RINGER SIMPLES 500 ML SI IV BS	5.9400	5.9367	0.0033	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	22896	CEFUROXIMA 750 MG + DIL. 6 ML PO IM IV FA	26.1300	26.1271	0.0029	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	22896	CEFUROXIMA 750 MG + DIL. 6 ML PO IM IV FA	26.1300	26.1271	0.0029	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4078	0.0022	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4078	0.0022	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4078	0.0022	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4078	0.0022	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4078	0.0022	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4078	0.0022	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4078	0.0022	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	33227	LUVA CIRURGICA PAR UN	1.4500	1.4476	0.0024	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	33227	LUVA CIRURGICA PAR UN	1.4500	1.4476	0.0024	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	33227	LUVA CIRURGICA PAR UN	1.4500	1.4476	0.0024	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.1038	-0.0038	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.1038	-0.0038	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	b288bbcfb9aecab51bcb0dba62ca0059	IVONETE	12743730847	NULL	12743730847	19160	SERINGA DESC 20 ML UN	0.5400	0.5367	0.0033	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	b288bbcfb9aecab51bcb0dba62ca0059	IVONETE	12743730847	NULL	12743730847	19160	SERINGA DESC 20 ML UN	0.5400	0.5367	0.0033	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	b288bbcfb9aecab51bcb0dba62ca0059	IVONETE	12743730847	NULL	12743730847	19160	SERINGA DESC 20 ML UN	0.5400	0.5367	0.0033	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1900	0.1900	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1900	0.1900	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	11193	CLOREXIDINA 2 % ST TP ML	0.5300	0.5300	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	33227	LUVA CIRURGICA PAR UN	1.4500	0.0000	1.4500	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	32891	EQUIPO POLIFIX 2ş VIAS UN	2.5500	0.0000	2.5500	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4084	0.0016	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4084	0.0016	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4084	0.0016	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4084	0.0016	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4084	0.0016	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4084	0.0016	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4084	0.0016	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4084	0.0016	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4084	0.0016	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	2a79bf9d53875b480086bd7b8321c4f1	JOSE	12641066643	NULL	12641066643	42358	FUROSEMIDA 10 MG/ML 2 ML SI IM IV AP	1.2000	1.1900	0.0000	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	2a79bf9d53875b480086bd7b8321c4f1	JOSE	12641066643	NULL	12641066643	12262	ISOSSORBIDA 20 MG CP VO UN	0.2200	0.2167	0.0033	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	00817	ALGODAO HIDROFILO BOLINHA UN	0.1300	0.0000	0.1300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	05975	COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER	0.3000	0.0000	0.3000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	32204	CLORETO DE SODIO 0,9% 10 ML SI IV AP	0.4800	0.0000	0.4800	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	32204	CLORETO DE SODIO 0,9% 10 ML SI IV AP	0.4800	0.4800	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	32204	CLORETO DE SODIO 0,9% 10 ML SI IV AP	0.4800	0.4800	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	32204	CLORETO DE SODIO 0,9% 10 ML SI IV AP	0.4800	0.0000	0.4800	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	32204	CLORETO DE SODIO 0,9% 10 ML SI IV AP	0.4800	0.0000	0.4800	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	00426	AGUA BIDESTILADA 10 ML SI IV IM AP	0.8100	0.8067	0.0033	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	00426	AGUA BIDESTILADA 10 ML SI IV IM AP	0.8100	0.8067	0.0033	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	00426	AGUA BIDESTILADA 10 ML SI IV IM AP	0.8100	0.8067	0.0033	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	00426	AGUA BIDESTILADA 10 ML SI IV IM AP	0.8100	0.8067	0.0033	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	00426	AGUA BIDESTILADA 10 ML SI IV IM AP	0.8100	0.8067	0.0033	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	00426	AGUA BIDESTILADA 10 ML SI IV IM AP	0.8100	0.8067	0.0033	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	32204	CLORETO DE SODIO 0,9% 10 ML SI IV AP	0.4800	0.0000	0.4800	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	32204	CLORETO DE SODIO 0,9% 10 ML SI IV AP	0.4800	0.0000	0.4800	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	32204	CLORETO DE SODIO 0,9% 10 ML SI IV AP	0.9600	0.9600	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	32204	CLORETO DE SODIO 0,9% 10 ML SI IV AP	0.4800	0.0000	0.4800	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00426	AGUA BIDESTILADA 10 ML SI IV IM AP	0.8100	0.0000	0.8100	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00426	AGUA BIDESTILADA 10 ML SI IV IM AP	0.8100	0.8080	0.0020	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	32204	CLORETO DE SODIO 0,9% 10 ML SI IV AP	0.9600	0.0000	0.9600	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	32204	CLORETO DE SODIO 0,9% 10 ML SI IV AP	0.9600	0.0000	0.9600	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	30376	BROMETO DE IPRATROPIO 0,25MG/ML SL IN GT	0.8000	0.0000	0.8000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	14460	DOMPERIDONA 10 MG CP VO UN	0.3900	0.0000	0.3900	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	32204	CLORETO DE SODIO 0,9% 10 ML SI IV AP	0.4800	0.0000	0.4800	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	e715e2ae28a6229c8609756d3298bf52	MARIA	12734221144	NULL	12734221144	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1750	0.0050	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	05975	COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER	0.3000	0.0000	0.3000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	11193	CLOREXIDINA 2 % ST TP ML	0.5300	0.5300	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	11193	CLOREXIDINA 2 % ST TP ML	0.5300	0.5300	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	05975	COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER	0.3000	0.3837	-0.0837	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	05975	COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER	0.3000	0.0000	0.3000	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	19119	SERINGA DESC 01 ML (INSULINA) UN	0.3100	0.3050	0.0050	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	33537	PIPERACILINA 2 G + TAZOBACTAM 250 MG 30 ML	55.3400	55.3375	0.0025	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	33537	PIPERACILINA 2 G + TAZOBACTAM 250 MG 30 ML	55.3400	55.3375	0.0025	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	33537	PIPERACILINA 2 G + TAZOBACTAM 250 MG 30 ML	55.3400	55.3375	0.0025	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	33537	PIPERACILINA 2 G + TAZOBACTAM 250 MG 30 ML	55.3400	55.3375	0.0025	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	42358	FUROSEMIDA 10 MG/ML 2 ML SI IM IV AP	1.2000	1.1964	0.0036	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	42358	FUROSEMIDA 10 MG/ML 2 ML SI IM IV AP	1.2000	1.1964	0.0036	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4061	0.0039	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4061	0.0039	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4061	0.0039	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4061	0.0039	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4061	0.0039	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	33227	LUVA CIRURGICA PAR UN	1.4500	1.4477	0.0023	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	33227	LUVA CIRURGICA PAR UN	1.4500	1.4477	0.0023	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	33227	LUVA CIRURGICA PAR UN	1.4500	1.4477	0.0023	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	33227	LUVA CIRURGICA PAR UN	1.4500	1.4477	0.0023	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	33227	LUVA CIRURGICA PAR UN	1.4500	1.4477	0.0023	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	33227	LUVA CIRURGICA PAR UN	1.4500	1.4477	0.0023	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	37761	ALCOOL ETILICO 70 % ST TP ML	0.0300	0.0000	0.0300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	37761	ALCOOL ETILICO 70 % ST TP ML	0.0300	0.0200	0.0100	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	22748	LIDOCAINA 2% GE TP OU GR	0.2600	0.0000	0.2600	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00817	ALGODAO HIDROFILO BOLINHA UN	0.1300	0.0000	0.1300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	19135	SERINGA DESC 03 ML UN	0.1500	0.0000	0.1500	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.2100	0.2057	0.0043	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1772	0.0028	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1772	0.0028	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1772	0.0028	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1772	0.0028	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1772	0.0028	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1772	0.0028	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1772	0.0028	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	08664	ESPARADRAPO MICROPORE 50 X 10 CM CM	0.7700	0.7670	0.0030	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	cd2840524be5a3f1d0939f241e24f32b	MARIA	12705908340	NULL	12705908340	32204	CLORETO DE SODIO 0,9% 10 ML SI IV AP	0.4800	0.0000	0.4800	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	cd2840524be5a3f1d0939f241e24f32b	MARIA	12705908340	NULL	12705908340	32204	CLORETO DE SODIO 0,9% 10 ML SI IV AP	0.4800	0.4800	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	cd2840524be5a3f1d0939f241e24f32b	MARIA	12705908340	NULL	12705908340	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1764	0.0036	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	cd2840524be5a3f1d0939f241e24f32b	MARIA	12705908340	NULL	12705908340	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1764	0.0036	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	d17b3c5ae418d82694895a326dee545a	ODILIA	12670516743	NULL	12670516743	30376	BROMETO DE IPRATROPIO 0,25MG/ML SL IN GT	0.4000	0.0000	0.4000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	d17b3c5ae418d82694895a326dee545a	ODILIA	12670516743	NULL	12670516743	30376	BROMETO DE IPRATROPIO 0,25MG/ML SL IN GT	0.4000	0.0000	0.4000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	d17b3c5ae418d82694895a326dee545a	ODILIA	12670516743	NULL	12670516743	30376	BROMETO DE IPRATROPIO 0,25MG/ML SL IN GT	0.4000	0.0000	0.4000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	d17b3c5ae418d82694895a326dee545a	ODILIA	12670516743	NULL	12670516743	32204	CLORETO DE SODIO 0,9% 10 ML SI IV AP	0.4800	0.0000	0.4800	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	d17b3c5ae418d82694895a326dee545a	ODILIA	12670516743	NULL	12670516743	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1774	0.0026	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	d17b3c5ae418d82694895a326dee545a	ODILIA	12670516743	NULL	12670516743	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1774	0.0026	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1766	0.0034	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1766	0.0034	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	8a5ecfde671848d05ac757e0112e689c	TEREZINHA	12700337042	NULL	12700337042	09733	ACETILCISTEINA 600MG PO VO SA	3.5000	3.4967	0.0033	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	8a5ecfde671848d05ac757e0112e689c	TEREZINHA	12700337042	NULL	12700337042	09733	ACETILCISTEINA 600MG PO VO SA	3.5000	3.4967	0.0033	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	8a5ecfde671848d05ac757e0112e689c	TEREZINHA	12700337042	NULL	12700337042	57258	FUMARATO DE QUETIAPINA 25 MG CA VO UN	1.2500	1.2450	0.0050	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	8a5ecfde671848d05ac757e0112e689c	TEREZINHA	12700337042	NULL	12700337042	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4071	0.0029	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	8a5ecfde671848d05ac757e0112e689c	TEREZINHA	12700337042	NULL	12700337042	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4071	0.0029	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	8a5ecfde671848d05ac757e0112e689c	TEREZINHA	12700337042	NULL	12700337042	19160	SERINGA DESC 20 ML UN	0.5400	0.5368	0.0032	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	8a5ecfde671848d05ac757e0112e689c	TEREZINHA	12700337042	NULL	12700337042	19160	SERINGA DESC 20 ML UN	0.5400	0.5376	0.0024	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	8a5ecfde671848d05ac757e0112e689c	TEREZINHA	12700337042	NULL	12700337042	19160	SERINGA DESC 20 ML UN	0.5400	0.5376	0.0024	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	8a5ecfde671848d05ac757e0112e689c	TEREZINHA	12700337042	NULL	12700337042	19160	SERINGA DESC 20 ML UN	0.5400	0.5376	0.0024	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	70cf23c63f890f0b61da2542c3e13a09	TIAGO	12741864645	NULL	12741864645	10634	GLICOSE 50% 20 ML SI IV AP	2.1400	2.1300	0.0000	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	70cf23c63f890f0b61da2542c3e13a09	TIAGO	12741864645	NULL	12741864645	32719	CEFAZOLINA 1 GR + DIL. 10 ML FA	16.2600	16.2500	0.0000	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	70cf23c63f890f0b61da2542c3e13a09	TIAGO	12741864645	NULL	12741864645	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1762	0.0038	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	70cf23c63f890f0b61da2542c3e13a09	TIAGO	12741864645	NULL	12741864645	19160	SERINGA DESC 20 ML UN	0.5400	0.5364	0.0036	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	70cf23c63f890f0b61da2542c3e13a09	TIAGO	12741864645	NULL	12741864645	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4075	0.0025	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	32204	CLORETO DE SODIO 0,9% 10 ML SI IV AP	0.9600	0.9600	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4070	0.0030	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	0111beed375944f60c7ad4a7fd4874f8	WALDIR	12746025744	NULL	12746025744	00426	AGUA BIDESTILADA 10 ML SI IV IM AP	1.6200	1.6147	0.0053	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	0111beed375944f60c7ad4a7fd4874f8	WALDIR	12746025744	NULL	12746025744	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4076	0.0024	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	0111beed375944f60c7ad4a7fd4874f8	WALDIR	12746025744	NULL	12746025744	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4076	0.0024	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	0111beed375944f60c7ad4a7fd4874f8	WALDIR	12746025744	NULL	12746025744	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4076	0.0024	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	0111beed375944f60c7ad4a7fd4874f8	WALDIR	12746025744	NULL	12746025744	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4076	0.0024	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	0111beed375944f60c7ad4a7fd4874f8	WALDIR	12746025744	NULL	12746025744	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4076	0.0024	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	0111beed375944f60c7ad4a7fd4874f8	WALDIR	12746025744	NULL	12746025744	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4076	0.0024	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	0111beed375944f60c7ad4a7fd4874f8	WALDIR	12746025744	NULL	12746025744	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4076	0.0024	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	0111beed375944f60c7ad4a7fd4874f8	WALDIR	12746025744	NULL	12746025744	19160	SERINGA DESC 20 ML UN	0.5400	0.5379	0.0021	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	0111beed375944f60c7ad4a7fd4874f8	WALDIR	12746025744	NULL	12746025744	19160	SERINGA DESC 20 ML UN	0.5400	0.5379	0.0021	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	0111beed375944f60c7ad4a7fd4874f8	WALDIR	12746025744	NULL	12746025744	19160	SERINGA DESC 20 ML UN	0.5400	0.5379	0.0021	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	0111beed375944f60c7ad4a7fd4874f8	WALDIR	12746025744	NULL	12746025744	19160	SERINGA DESC 20 ML UN	0.5400	0.5379	0.0021	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	00817	ALGODAO HIDROFILO BOLINHA UN	0.1300	0.0000	0.1300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	00817	ALGODAO HIDROFILO BOLINHA UN	0.2600	0.0000	0.2600	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	52353	ABAIXADOR DE LINGUA UN	0.0500	0.0267	0.0233	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	00817	ALGODAO HIDROFILO BOLINHA UN	0.2600	0.0000	0.2600	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	00817	ALGODAO HIDROFILO BOLINHA UN	0.2600	0.0000	0.2600	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	00817	ALGODAO HIDROFILO BOLINHA UN	0.5100	0.0000	0.5100	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	37761	ALCOOL ETILICO 70 % ST TP ML	0.0600	0.0000	0.0600	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	27596	TIRA TESTE PARA GLICOSE UN	1.0400	1.0400	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	27596	TIRA TESTE PARA GLICOSE UN	1.0400	1.0400	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	27596	TIRA TESTE PARA GLICOSE UN	1.0400	1.0400	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	05975	COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER	0.3000	0.0000	0.3000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	05975	COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER	0.3000	0.0000	0.3000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	05975	COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER	0.6000	0.0000	0.6000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12662414945	NULL	12662414945	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1750	0.0050	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12662414945	NULL	12662414945	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4071	0.0029	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12579183644	NULL	12579183644	05975	COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER	0.3000	0.1500	0.1500	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12579183644	NULL	12579183644	33227	LUVA CIRURGICA PAR UN	1.4500	1.4476	0.0024	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12579183644	NULL	12579183644	33227	LUVA CIRURGICA PAR UN	1.4500	1.4476	0.0024	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1770	0.0030	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1770	0.0030	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1770	0.0030	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1770	0.0030	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	NULL	0.0000	NULL	OPME INVALIDO	2201
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	34789	SONDA ASPIRAÇAO C/ VALVULA - TODAS - UTI UN	0.9400	0.9365	0.0035	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	25798	LOSARTANA 50 MG CP VO UN	1.3300	0.0000	1.3300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	19151	SERINGA DESC 10 ML UN	0.3300	0.0000	0.3300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.0000	0.1000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.2120	-0.1120	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.2120	-0.1120	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.1060	-0.0060	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.1060	-0.0060	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.1060	-0.0060	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.1060	-0.0060	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.1060	-0.0060	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.1060	-0.0060	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.1060	-0.0060	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.1060	-0.0060	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	34827	TIORFAN (RACECADOTRILA) 100 MG CA VO UN	3.2000	6.4000	-3.2000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	34827	TIORFAN (RACECADOTRILA) 100 MG CA VO UN	3.2000	3.2000	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	27596	TIRA TESTE PARA GLICOSE UN	1.0400	2.0800	-1.0400	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	27596	TIRA TESTE PARA GLICOSE UN	1.0400	1.0400	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	19160	SERINGA DESC 20 ML UN	0.5400	0.5374	0.0026	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	19160	SERINGA DESC 20 ML UN	0.5400	0.5374	0.0026	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	19160	SERINGA DESC 20 ML UN	0.5400	0.5374	0.0026	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	31585	RANITIDINA 25 MG/ML 2 ML SI IV IM AP	0.9300	1.8668	-0.9368	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	31585	RANITIDINA 25 MG/ML 2 ML SI IV IM AP	0.9300	0.9334	-0.0034	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	31585	RANITIDINA 25 MG/ML 2 ML SI IV IM AP	0.9300	0.9334	-0.0034	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	31585	RANITIDINA 25 MG/ML 2 ML SI IV IM AP	0.9300	0.9334	-0.0034	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	19151	SERINGA DESC 10 ML UN	0.6634	1.0003	-0.6703	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	19151	SERINGA DESC 10 ML UN	0.3300	0.6669	-0.3369	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	19151	SERINGA DESC 10 ML UN	0.3300	0.6669	-0.3369	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	19151	SERINGA DESC 10 ML UN	0.3300	0.6669	-0.3369	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	19151	SERINGA DESC 10 ML UN	0.3300	0.6669	-0.3369	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	19151	SERINGA DESC 10 ML UN	0.3300	0.6669	-0.3369	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	19151	SERINGA DESC 10 ML UN	0.3300	0.6669	-0.3369	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	19151	SERINGA DESC 10 ML UN	0.3300	0.6669	-0.3369	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	19151	SERINGA DESC 10 ML UN	0.3300	0.6669	-0.3369	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	19151	SERINGA DESC 10 ML UN	0.3300	0.6669	-0.3369	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	13935	METAMUCIL (PLANTAGO OVATA) 5,85 G PO VO E	4.9236	7.3907	-4.9307	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	07269	DIPIRONA 500 MG/ML 2 ML SI IV IM AP	0.6900	0.6860	0.0040	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	37761	ALCOOL ETILICO 70 % ST TP ML	0.0631	0.0695	-0.0395	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	37761	ALCOOL ETILICO 70 % ST TP ML	0.0598	0.0662	-0.0362	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	21822	TRAMADOL 50 MG 1 ML SI IM IV AP	25.1571	29.3540	-25.1640	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	11193	CLOREXIDINA 2 % ST TP ML	0.5300	0.5320	-0.0020	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	11193	CLOREXIDINA 2 % ST TP ML	0.5300	0.5320	-0.0020	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	800720d33fe0defb6121e82dd216d044	JALMO	12786952647	NULL	12786952647	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	800720d33fe0defb6121e82dd216d044	JALMO	12786952647	NULL	12786952647	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	800720d33fe0defb6121e82dd216d044	JALMO	12786952647	NULL	12786952647	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	11700	EQUIPO P/ BOMBA DE INFUSAO ENTERAL / PARENTERAL	0.0000	20.2800	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4075	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00172	SORO FISIOLOGICO 0,9% 500 ML SI IV BS	0.0000	4.7300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00172	SORO FISIOLOGICO 0,9% 500 ML SI IV BS	0.0000	4.7300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	02246	HIDROCORTISONA 100 MG PO IM IV FA	0.0000	2.8300	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	02246	HIDROCORTISONA 100 MG PO IM IV FA	0.0000	5.6700	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	02246	HIDROCORTISONA 100 MG PO IM IV FA	0.0000	5.6700	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	26981	SORO FISIOLOGICO 0,9% 10 ML SI IV AP	0.0000	0.0000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	26981	SORO FISIOLOGICO 0,9% 10 ML SI IV AP	0.0000	0.0000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00613	CLINDAMICINA 600 MG 4 ML SI IM IV AP	0.0000	13.0800	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00613	CLINDAMICINA 600 MG 4 ML SI IM IV AP	0.0000	13.0800	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00735	CEFTRIAXONA IV 1G + DIL. 10 ML PO IV FA	0.0000	54.1300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	07802	PIPERACILINA 4 G + TAZOBACTAM 500 MG PO IV FA	0.0000	83.4500	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	07802	PIPERACILINA 4 G + TAZOBACTAM 500 MG PO IV FA	0.0000	0.0000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	09071	ACETILCISTEINA 600MG PO VO SA	0.0000	3.4950	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	09071	ACETILCISTEINA 600MG PO VO SA	0.0000	3.4950	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00091	SERINGA DESC 01 ML (INSULINA) UN	0.0000	0.3058	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00124	LUVA CIRURGICA UN	0.0000	1.4475	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4062	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4062	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4062	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4062	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4062	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4062	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4062	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	01584	NEOSTIGMINA 0,5 MG/ML 1 ML SI IM IV SC AP	0.0000	0.7667	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	01584	NEOSTIGMINA 0,5 MG/ML 1 ML SI IM IV SC AP	0.0000	0.7667	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	01584	NEOSTIGMINA 0,5 MG/ML 1 ML SI IM IV SC AP	0.0000	0.7667	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00170	SORO GLICOSADO 5% 250 ML SI IV BS	0.0000	3.4000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	24082	BROMOPRIDA 5 MG/ML 2 ML SI IM IV AP	0.0000	2.7300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	24082	BROMOPRIDA 5 MG/ML 2 ML SI IM IV AP	0.0000	2.7300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	902001	PLANTAO DE UTI POR PACIENTE (HONORARIO)	0.0000	4558.7200	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00090	SERINGA DESC 20 ML UN	0.0000	0.5371	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00090	SERINGA DESC 20 ML UN	0.0000	0.5371	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00090	SERINGA DESC 20 ML UN	0.0000	0.5371	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00090	SERINGA DESC 20 ML UN	0.0000	0.5371	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00090	SERINGA DESC 20 ML UN	0.0000	0.5371	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00090	SERINGA DESC 20 ML UN	0.0000	0.5371	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00090	SERINGA DESC 20 ML UN	0.0000	0.5371	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00090	SERINGA DESC 20 ML UN	0.0000	0.5371	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00090	SERINGA DESC 20 ML UN	0.0000	0.5371	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00090	SERINGA DESC 20 ML UN	0.0000	0.5371	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00090	SERINGA DESC 20 ML UN	0.0000	0.5371	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00090	SERINGA DESC 20 ML UN	0.0000	0.5371	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4064	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4088	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4088	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4088	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4088	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4088	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4088	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4088	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1766	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1766	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1766	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1766	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1766	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1766	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00090	SERINGA DESC 20 ML UN	0.0000	0.5387	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00090	SERINGA DESC 20 ML UN	0.0000	0.5387	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00090	SERINGA DESC 20 ML UN	0.0000	0.5387	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00090	SERINGA DESC 20 ML UN	0.0000	0.5387	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00090	SERINGA DESC 20 ML UN	0.0000	0.5400	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00090	SERINGA DESC 20 ML UN	0.0000	0.5387	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00090	SERINGA DESC 20 ML UN	0.0000	0.5387	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00090	SERINGA DESC 20 ML UN	0.0000	0.5387	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00090	SERINGA DESC 20 ML UN	0.0000	0.5387	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00090	SERINGA DESC 20 ML UN	0.0000	0.5387	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00090	SERINGA DESC 20 ML UN	0.0000	0.5387	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00090	SERINGA DESC 20 ML UN	0.0000	0.5387	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00090	SERINGA DESC 20 ML UN	0.0000	0.5387	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4060	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12550571048	NULL	12550571048	11700	EQUIPO P/ BOMBA DE INFUSAO ENTERAL / PARENTERAL	0.0000	8.0200	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12550571048	NULL	12550571048	00124	LUVA CIRURGICA UN	0.0000	1.4473	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12550571048	NULL	12550571048	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4074	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12550571048	NULL	12550571048	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4074	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12550571048	NULL	12550571048	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4074	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12550571048	NULL	12550571048	00170	SORO GLICOSADO 5% 250 ML SI IV BS	0.0000	3.4000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12550571048	NULL	12550571048	25030019	Distúrbios Circulatórios Artério - Venosos e Linfáticos	0.0000	0.0000	NULL	EXAME NAO AUTORIZADO	2707
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12550571048	NULL	12550571048	25040014	Fisioterapia Respiratória - em Doente Clínico Internado	0.0000	10.0600	NULL	EXAME NAO AUTORIZADO	2707
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12550571048	NULL	12550571048	29020166	Nebulização Simples com Broncodilatador	0.0000	7.0200	NULL	EXAME NAO AUTORIZADO	2707
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12550571048	NULL	12550571048	29020166	Nebulização Simples com Broncodilatador	0.0000	7.0200	NULL	EXAME NAO AUTORIZADO	2707
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12550571048	NULL	12550571048	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.0000	0.8089	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12550571048	NULL	12550571048	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.0000	0.8089	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12550571048	NULL	12550571048	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1775	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12550571048	NULL	12550571048	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1775	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12550571048	NULL	12550571048	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1775	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12550571048	NULL	12550571048	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1775	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12550571048	NULL	12550571048	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1775	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12550571048	NULL	12550571048	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1775	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12550571048	NULL	12550571048	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1775	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12550571048	NULL	12550571048	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1775	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12579183644	NULL	12579183644	00124	LUVA CIRURGICA UN	0.0000	1.4476	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12579183644	NULL	12579183644	00124	LUVA CIRURGICA UN	0.0000	1.4476	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12579183644	NULL	12579183644	00124	LUVA CIRURGICA UN	0.0000	1.4476	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12579183644	NULL	12579183644	25040014	Fisioterapia Respiratória - em Doente Clínico Internado	0.0000	10.0600	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12579183644	NULL	12579183644	25040014	Fisioterapia Respiratória - em Doente Clínico Internado	0.0000	10.0600	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12579183644	NULL	12579183644	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12579183644	NULL	12579183644	35382	COMPRESSAS DE GASES 7.5 X7,5 (11 FIOS ESTERIL) UN	0.0000	0.0000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12579183644	NULL	12579183644	35382	COMPRESSAS DE GASES 7.5 X7,5 (11 FIOS ESTERIL) UN	0.0000	0.3000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12579183644	NULL	12579183644	35382	COMPRESSAS DE GASES 7.5 X7,5 (11 FIOS ESTERIL) UN	0.0000	0.3000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12579183644	NULL	12579183644	35382	COMPRESSAS DE GASES 7.5 X7,5 (11 FIOS ESTERIL) UN	0.0000	0.1909	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12579183644	NULL	12579183644	35382	COMPRESSAS DE GASES 7.5 X7,5 (11 FIOS ESTERIL) UN	0.0000	0.3000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	00124	LUVA CIRURGICA UN	0.0000	1.4482	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	00124	LUVA CIRURGICA UN	0.0000	1.4482	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	00124	LUVA CIRURGICA UN	0.0000	1.4482	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	00128	LUVA DE PROCEDIMENTO UNIDADE UN	0.0000	1.6700	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	00128	LUVA DE PROCEDIMENTO UNIDADE UN	0.0000	1.6700	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.0000	0.4000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.0000	0.4000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1752	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	51241	AGULHA 123X45	0.0000	0.1900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	51241	AGULHA 123X45	0.0000	0.1900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	51241	AGULHA 123X45	0.0000	0.1900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	51241	AGULHA 123X45	0.0000	0.1900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	51241	AGULHA 123X45	0.0000	0.1900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	51241	AGULHA 123X45	0.0000	0.1900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	51241	AGULHA 123X45	0.0000	0.1900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	51590	ABAIXADOR DE LINGUA UN	0.0000	0.0500	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	52392	SONDA DE ASPIRAÇAO TRAQUEAL C/ VALVULA UN	0.0000	0.9352	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	52392	SONDA DE ASPIRAÇAO TRAQUEAL C/ VALVULA UN	0.0000	0.9352	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	52392	SONDA DE ASPIRAÇAO TRAQUEAL C/ VALVULA UN	0.0000	0.9352	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	52392	SONDA DE ASPIRAÇAO TRAQUEAL C/ VALVULA UN	0.0000	0.9352	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	52392	SONDA DE ASPIRAÇAO TRAQUEAL C/ VALVULA UN	0.0000	0.9400	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	52392	SONDA DE ASPIRAÇAO TRAQUEAL C/ VALVULA UN	0.0000	0.9352	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.0000	0.6874	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.0000	0.6874	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.0000	0.6874	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1775	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.3500	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.3500	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	53945	ACIDO ASCORBICO 500 MG CP VO UN	0.0000	0.5900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	53945	ACIDO ASCORBICO 500 MG CP VO UN	0.0000	0.5900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	53945	ACIDO ASCORBICO 500 MG CP VO UN	0.0000	0.5900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	54653	DERSANI LC TP ML	0.0000	0.0000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00128	LUVA DE PROCEDIMENTO UNIDADE UN	0.0000	0.6700	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	01496	FENITOINA 50 MG/ML 5 ML SI IM IV AP	0.0000	2.3400	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	01496	FENITOINA 50 MG/ML 5 ML SI IM IV AP	0.0000	2.3400	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	01496	FENITOINA 50 MG/ML 5 ML SI IM IV AP	0.0000	2.3400	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	01584	NEOSTIGMINA 0,5 MG/ML 1 ML SI IM IV SC AP	0.0000	0.7662	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00169	SORO GLICOSADO 5% 500 ML SI IV BS	0.0000	3.6715	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	24082	BROMOPRIDA 5 MG/ML 2 ML SI IM IV AP	0.0000	2.7300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	24082	BROMOPRIDA 5 MG/ML 2 ML SI IM IV AP	0.0000	2.7300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	24082	BROMOPRIDA 5 MG/ML 2 ML SI IM IV AP	0.0000	2.7300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	26981	SORO FISIOLOGICO 0,9% 10 ML SI IV AP	0.0000	0.9600	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	ea4ad2636c25d8e3dbb569ae62db71e7	IONE	12489788840	NULL	12489788840	29020166	Nebulização Simples com Broncodilatador	0.0000	1.2200	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	ea4ad2636c25d8e3dbb569ae62db71e7	IONE	12489788840	NULL	12489788840	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1800	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	d17b3c5ae418d82694895a326dee545a	ODILIA	12670516743	NULL	12670516743	102001	DIARIA DE APARTAMENTO	0.0000	288.8882	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	d17b3c5ae418d82694895a326dee545a	ODILIA	12670516743	NULL	12670516743	102001	DIARIA DE APARTAMENTO	0.0000	288.8882	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	d17b3c5ae418d82694895a326dee545a	ODILIA	12670516743	NULL	12670516743	01229	FLEET ENEMA (FOSFATO DE SODIO DIBASICO + FOSFATO	0.0000	0.0000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	d17b3c5ae418d82694895a326dee545a	ODILIA	12670516743	NULL	12670516743	00128	LUVA DE PROCEDIMENTO UNIDADE UN	0.0000	1.0000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	d17b3c5ae418d82694895a326dee545a	ODILIA	12670516743	NULL	12670516743	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	d17b3c5ae418d82694895a326dee545a	ODILIA	12670516743	NULL	12670516743	02197	METAMUCIL (PLANTAGO OVATA) 3,4 G PO VO EV	0.0000	2.4600	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	d17b3c5ae418d82694895a326dee545a	ODILIA	12670516743	NULL	12670516743	02197	METAMUCIL (PLANTAGO OVATA) 3,4 G PO VO EV	0.0000	2.4600	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	d17b3c5ae418d82694895a326dee545a	ODILIA	12670516743	NULL	12670516743	02197	METAMUCIL (PLANTAGO OVATA) 3,4 G PO VO EV	0.0000	2.4600	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	d17b3c5ae418d82694895a326dee545a	ODILIA	12670516743	NULL	12670516743	02197	METAMUCIL (PLANTAGO OVATA) 3,4 G PO VO EV	0.0000	2.4600	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	d17b3c5ae418d82694895a326dee545a	ODILIA	12670516743	NULL	12670516743	25030019	Distúrbios Circulatórios Artério - Venosos e Linfáticos	0.0000	0.0000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	d17b3c5ae418d82694895a326dee545a	ODILIA	12670516743	NULL	12670516743	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	d17b3c5ae418d82694895a326dee545a	ODILIA	12670516743	NULL	12670516743	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1965b0cdebe9017c3397c8641147759	JOSE	12705413746	NULL	12705413746	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4074	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1965b0cdebe9017c3397c8641147759	JOSE	12705413746	NULL	12705413746	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4074	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1965b0cdebe9017c3397c8641147759	JOSE	12705413746	NULL	12705413746	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4074	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1965b0cdebe9017c3397c8641147759	JOSE	12705413746	NULL	12705413746	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4074	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1965b0cdebe9017c3397c8641147759	JOSE	12705413746	NULL	12705413746	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4074	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1965b0cdebe9017c3397c8641147759	JOSE	12705413746	NULL	12705413746	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4074	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1965b0cdebe9017c3397c8641147759	JOSE	12705413746	NULL	12705413746	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4074	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1965b0cdebe9017c3397c8641147759	JOSE	12705413746	NULL	12705413746	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4074	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4072	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4072	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	01611	CLORETO DE POTASSIO 600 MG CA VO UN	0.0000	0.4867	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	02246	HIDROCORTISONA 100 MG PO IM IV FA	0.0000	2.8300	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	02246	HIDROCORTISONA 100 MG PO IM IV FA	0.0000	2.8300	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	02246	HIDROCORTISONA 100 MG PO IM IV FA	0.0000	2.8300	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	26981	SORO FISIOLOGICO 0,9% 10 ML SI IV AP	0.0000	0.4800	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	00404	LACTULOSE 667 MG/ML XP VO ML	0.0000	0.0000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	00404	LACTULOSE 667 MG/ML XP VO ML	0.0000	0.2100	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	00404	LACTULOSE 667 MG/ML XP VO ML	0.0000	6.4300	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	00404	LACTULOSE 667 MG/ML XP VO ML	0.0000	6.4300	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1771	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1771	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1771	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1771	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1771	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1771	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1771	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	081fdadb830fb547e83c43fabdb88372	ELZA	12377335349	NULL	12377335349	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1800	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	081fdadb830fb547e83c43fabdb88372	ELZA	12377335349	NULL	12377335349	09071	ACETILCISTEINA 600MG PO VO SA	0.0000	3.5000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	081fdadb830fb547e83c43fabdb88372	ELZA	12377335349	NULL	12377335349	09071	ACETILCISTEINA 600MG PO VO SA	0.0000	3.5000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	081fdadb830fb547e83c43fabdb88372	ELZA	12377335349	NULL	12377335349	09071	ACETILCISTEINA 600MG PO VO SA	0.0000	3.5000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	081fdadb830fb547e83c43fabdb88372	ELZA	12377335349	NULL	12377335349	09071	ACETILCISTEINA 600MG PO VO SA	0.0000	3.5000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	081fdadb830fb547e83c43fabdb88372	ELZA	12377335349	NULL	12377335349	00098	ABOCATH N 14 A 22 UN	0.0000	3.7700	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	00172	SORO FISIOLOGICO 0,9% 500 ML SI IV BS	0.0000	9.4698	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	00172	SORO FISIOLOGICO 0,9% 500 ML SI IV BS	0.0000	9.4698	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	02355	AMOXICILINA 1 G + CLAVULANATO 200 MG + DIL. 10 ML	0.0000	36.4600	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	24571	CLINDAMICINA 600 MG 4 ML SI IM IV AP	0.0000	13.0800	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	24571	CLINDAMICINA 600 MG 4 ML SI IM IV AP	0.0000	13.0800	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	24571	CLINDAMICINA 600 MG 4 ML SI IM IV AP	0.0000	13.0800	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	dd486d36a88cfef0b44fe652638a0164	DELFINA	12660326244	NULL	12660326244	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR APRESENTADO A MAIOR	1705
Glosa Min	2018-10-03 00:00:00.000000	1084117	dd486d36a88cfef0b44fe652638a0164	DELFINA	12660326244	NULL	12660326244	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	dd486d36a88cfef0b44fe652638a0164	DELFINA	12660326244	NULL	12660326244	35382	COMPRESSAS DE GASES 7.5 X7,5 (11 FIOS ESTERIL) UN	0.0000	0.3000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	dd486d36a88cfef0b44fe652638a0164	DELFINA	12660326244	NULL	12660326244	00406	FUROSEMIDA 10 MG/ML 2 ML SI IM IV AP	0.0000	0.6000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	dd486d36a88cfef0b44fe652638a0164	DELFINA	12660326244	NULL	12660326244	00406	FUROSEMIDA 10 MG/ML 2 ML SI IM IV AP	0.0000	1.2000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	dd486d36a88cfef0b44fe652638a0164	DELFINA	12660326244	NULL	12660326244	00487	RANITIDINA 25 MG/ML 2 ML SI IM IV AP	0.0000	0.9300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	dd486d36a88cfef0b44fe652638a0164	DELFINA	12660326244	NULL	12660326244	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.0000	0.8100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	dd486d36a88cfef0b44fe652638a0164	DELFINA	12660326244	NULL	12660326244	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.0000	0.8100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	dd486d36a88cfef0b44fe652638a0164	DELFINA	12660326244	NULL	12660326244	51379	SERINGA DESC 05 ML UN	0.0000	0.1900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	dd486d36a88cfef0b44fe652638a0164	DELFINA	12660326244	NULL	12660326244	51379	SERINGA DESC 05 ML UN	0.0000	0.1900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	dd486d36a88cfef0b44fe652638a0164	DELFINA	12660326244	NULL	12660326244	51379	SERINGA DESC 05 ML UN	0.0000	0.1900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	dd486d36a88cfef0b44fe652638a0164	DELFINA	12660326244	NULL	12660326244	51379	SERINGA DESC 05 ML UN	0.0000	0.1900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	dd486d36a88cfef0b44fe652638a0164	DELFINA	12660326244	NULL	12660326244	51497	ESPIRONOLACTONA 50 MG + HIDROCLOROTIAZIDA 50 MG	0.0000	0.9800	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	dd486d36a88cfef0b44fe652638a0164	DELFINA	12660326244	NULL	12660326244	51589	ESPARADRAPO 10 X 4.5 CM CM	0.0000	0.4000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	dd486d36a88cfef0b44fe652638a0164	DELFINA	12660326244	NULL	12660326244	00541	AMIODARONA 200 MG CP VO UN	0.0000	0.8400	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	dd486d36a88cfef0b44fe652638a0164	DELFINA	12660326244	NULL	12660326244	00541	AMIODARONA 200 MG CP VO UN	0.0000	0.8400	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	dd486d36a88cfef0b44fe652638a0164	DELFINA	12660326244	NULL	12660326244	54685	POLVIDINE ALCOOLICA	0.0000	0.6000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	102001	DIARIA DE APARTAMENTO	0.0000	288.8900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	11325	EQUIPO MACRO-GOTAS FLEXIVEL C/ INJETOR LATERAL UN	0.0000	1.5900	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	11325	EQUIPO MACRO-GOTAS FLEXIVEL C/ INJETOR LATERAL UN	0.0000	3.1800	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	11325	EQUIPO MACRO-GOTAS FLEXIVEL C/ INJETOR LATERAL UN	0.0000	3.1800	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	00128	LUVA DE PROCEDIMENTO UNIDADE UN	0.0000	1.0000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	51649	ALCOOL ETILICO 70 % ST TP ML	0.0000	0.0300	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	54995	EQUIPO P/ BOMBA DE INFUSAO ENTERAL / PARENTERAL U UN	0.0000	20.2800	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	00090	SERINGA DESC 20 ML UN	0.0000	0.5400	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	00090	SERINGA DESC 20 ML UN	0.0000	0.5400	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	00090	SERINGA DESC 20 ML UN	0.0000	0.5400	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	00943	EQUIPO POLIFIX 2 VIAS UN	0.0000	2.5500	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	f3ad474c8c562757c4d1a959ff0961c4	DJALMA	12718763240	NULL	12718763240	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	f3ad474c8c562757c4d1a959ff0961c4	DJALMA	12718763240	NULL	12718763240	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	f3ad474c8c562757c4d1a959ff0961c4	DJALMA	12718763240	NULL	12718763240	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	f3ad474c8c562757c4d1a959ff0961c4	DJALMA	12718763240	NULL	12718763240	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	f3ad474c8c562757c4d1a959ff0961c4	DJALMA	12718763240	NULL	12718763240	51584	ESPARADRAPO MICROPORE	0.0000	0.2600	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	f3ad474c8c562757c4d1a959ff0961c4	DJALMA	12718763240	NULL	12718763240	51584	ESPARADRAPO MICROPORE	0.0000	0.7700	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	f3ad474c8c562757c4d1a959ff0961c4	DJALMA	12718763240	NULL	12718763240	51584	ESPARADRAPO MICROPORE	0.0000	0.7700	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	f3ad474c8c562757c4d1a959ff0961c4	DJALMA	12718763240	NULL	12718763240	00090	SERINGA DESC 20 ML UN	0.0000	0.5400	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	f3ad474c8c562757c4d1a959ff0961c4	DJALMA	12718763240	NULL	12718763240	00090	SERINGA DESC 20 ML UN	0.0000	0.5400	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00090	SERINGA DESC 20 ML UN	0.5400	0.2200	0.3200	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00090	SERINGA DESC 20 ML UN	0.5400	0.2200	0.3200	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.6900	0.2700	0.4200	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.6900	0.2700	0.4200	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.6900	0.2700	0.4200	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00128	LUVA DE PROCEDIMENTO UNIDADE UN	1.0000	0.3900	0.6100	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00128	LUVA DE PROCEDIMENTO UNIDADE UN	1.0000	0.3900	0.6100	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	56456	ZOLPIDEM 10 MG CP VO UN	1.2800	0.4900	0.7900	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00493	BROMOPRIDA 5 MG/ML 2 ML SI IM IV AP	2.7300	1.0600	1.6700	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00493	BROMOPRIDA 5 MG/ML 2 ML SI IM IV AP	2.7300	1.0600	1.6700	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00493	BROMOPRIDA 5 MG/ML 2 ML SI IM IV AP	2.7300	1.0600	1.6700	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00493	BROMOPRIDA 5 MG/ML 2 ML SI IM IV AP	2.7300	1.0600	1.6700	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	51673	ALGINATO DE CALCIO EM HIDROGEL GL TP GR	3.4500	1.3400	2.1100	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	51673	ALGINATO DE CALCIO EM HIDROGEL GL TP GR	3.4500	1.3400	2.1100	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00172	SORO FISIOLOGICO 0,9% 500 ML SI IV BS	4.7300	1.8400	2.8900	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	53144	TRAMAL	5.9900	2.3300	3.6600	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	53144	TRAMAL	5.9900	2.3300	3.6600	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	53144	TRAMAL	5.9900	2.3300	3.6600	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	51620	Modulo Em Pó De Fibras Solúveis	7.3100	2.8500	4.4600	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	51673	ALGINATO DE CALCIO EM HIDROGEL GL TP GR	17.2500	6.7300	10.5200	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	51673	ALGINATO DE CALCIO EM HIDROGEL GL TP GR	17.2500	6.7300	10.5200	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	51673	ALGINATO DE CALCIO EM HIDROGEL GL TP GR	17.2500	6.7300	10.5200	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	16b1e9f62f247f02ad5cac910ee15b4e	BERCHOLINA	12631612848	NULL	12631612848	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4081	0.0019	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	16b1e9f62f247f02ad5cac910ee15b4e	BERCHOLINA	12631612848	NULL	12631612848	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4081	0.0019	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	16b1e9f62f247f02ad5cac910ee15b4e	BERCHOLINA	12631612848	NULL	12631612848	36432	HIDROCLOROTIAZIDA 25 MG CP VO UN	0.2400	0.2300	0.0100	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	16b1e9f62f247f02ad5cac910ee15b4e	BERCHOLINA	12631612848	NULL	12631612848	00090	SERINGA DESC 20 ML UN	0.5400	0.5200	0.0200	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12550571048	NULL	12550571048	05975	COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER	0.3000	0.1500	0.1500	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12550571048	NULL	12550571048	00817	ALGODAO HIDROFILO BOLINHA UN	0.2600	0.1300	0.1300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12550571048	NULL	12550571048	00817	ALGODAO HIDROFILO BOLINHA UN	0.5100	0.1300	0.3800	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12550571048	NULL	12550571048	05975	COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER	0.6000	0.1500	0.4500	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12550571048	NULL	12550571048	37761	ALCOOL ETILICO 70 % ST TP ML	0.0600	0.0200	0.0400	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12550571048	NULL	12550571048	33219	LUVA DE PROCEDIMENTO UNIDADE UN	1.6700	0.6700	1.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12550571048	NULL	12550571048	33219	LUVA DE PROCEDIMENTO UNIDADE UN	1.6700	0.6700	1.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	37761	ALCOOL ETILICO 70 % ST TP ML	0.0300	0.0000	0.0300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	75bcd473a0dc7c7a6751499b38a4a034	JOAQUIM	12692852143	NULL	12692852143	00817	ALGODAO HIDROFILO BOLINHA UN	0.2600	0.1300	0.1300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	75bcd473a0dc7c7a6751499b38a4a034	JOAQUIM	12692852143	NULL	12692852143	37761	ALCOOL ETILICO 70 % ST TP ML	0.0300	0.0200	0.0100	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	4668d2494ed6c4b2d18be299efcb26a2	JOAO	12469689344	NULL	12469689344	08648	ESPARADRAPO 10 X 4.5 CM CM	2.0000	1.2800	0.7200	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	4668d2494ed6c4b2d18be299efcb26a2	JOAO	12469689344	NULL	12469689344	08664	ESPARADRAPO MICROPORE 50 X 10 CM CM	0.7700	0.2600	0.5100	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	4668d2494ed6c4b2d18be299efcb26a2	JOAO	12469689344	NULL	12469689344	08648	ESPARADRAPO 10 X 4.5 CM CM	0.4000	0.2600	0.1400	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	4668d2494ed6c4b2d18be299efcb26a2	JOAO	12469689344	NULL	12469689344	17310	IODOPOVIDONA ALCOOLICA SL TP ML	0.6000	0.3000	0.3000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	37761	ALCOOL ETILICO 70 % ST TP ML	0.0600	0.0300	0.0300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	12572	KIT CATETER DUPLO LUMEM P/ HEMODIALISE UN	183.0000	0.0000	183.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	19151	SERINGA DESC 10 ML UN	0.3300	0.0000	0.3300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.0000	0.1000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	33219	LUVA DE PROCEDIMENTO UNIDADE UN	1.0000	0.6700	0.3300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	05975	COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER	0.3000	0.0000	0.3000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	00817	ALGODAO HIDROFILO BOLINHA UN	0.2600	0.1300	0.1300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	33219	LUVA DE PROCEDIMENTO UNIDADE UN	1.0000	0.6700	0.3300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	00817	ALGODAO HIDROFILO BOLINHA UN	0.2600	0.1300	0.1300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	32891	EQUIPO POLIFIX 2ş VIAS UN	2.5500	0.0000	2.5500	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	28959	DERSANI LC TP ML	19.4000	9.7000	9.7000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	33219	LUVA DE PROCEDIMENTO UNIDADE UN	1.0000	0.6700	0.3300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	11940	INSULINA NPH/REGULAR SI SC UI	0.4000	0.0000	0.4000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	32891	EQUIPO POLIFIX 2ş VIAS UN	2.5500	0.0000	2.5500	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	53660	EQUIPO MACRO-GOTAS FLEXIVEL C/ INJETOR LATE	1.5900	0.0000	1.5900	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12558131243	NULL	12558131243	11193	CLOREXIDINA 2 % ST TP ML	0.5300	0.2700	0.2600	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00817	ALGODAO HIDROFILO BOLINHA UN	0.2600	0.1300	0.1300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	7c2bc8cd9bbf9ce081562a3c63fff8c9	MARTA	12647505849	NULL	12647505849	19160	SERINGA DESC 20 ML UN	0.5400	0.5300	0.0000	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	7c2bc8cd9bbf9ce081562a3c63fff8c9	MARTA	12647505849	NULL	12647505849	22896	CEFUROXIMA 750 MG + DIL. 6 ML PO IM IV FA	26.1300	26.1250	0.0050	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	7c2bc8cd9bbf9ce081562a3c63fff8c9	MARTA	12647505849	NULL	12647505849	22896	CEFUROXIMA 750 MG + DIL. 6 ML PO IM IV FA	26.1300	26.1250	0.0050	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	7c2bc8cd9bbf9ce081562a3c63fff8c9	MARTA	12647505849	NULL	12647505849	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1756	0.0044	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	f65f553befc0e3bc8bd5bce5c1c6e413	NAIRLENE	12633078944	NULL	12633078944	33219	LUVA DE PROCEDIMENTO UNIDADE UN	1.6700	1.6650	0.0050	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	f65f553befc0e3bc8bd5bce5c1c6e413	NAIRLENE	12633078944	NULL	12633078944	19160	SERINGA DESC 20 ML UN	0.5400	0.5367	0.0033	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	f65f553befc0e3bc8bd5bce5c1c6e413	NAIRLENE	12633078944	NULL	12633078944	19160	SERINGA DESC 20 ML UN	0.5400	0.5367	0.0033	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	f65f553befc0e3bc8bd5bce5c1c6e413	NAIRLENE	12633078944	NULL	12633078944	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4062	0.0038	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	f65f553befc0e3bc8bd5bce5c1c6e413	NAIRLENE	12633078944	NULL	12633078944	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4067	0.0033	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	f65f553befc0e3bc8bd5bce5c1c6e413	NAIRLENE	12633078944	NULL	12633078944	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4067	0.0033	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	f65f553befc0e3bc8bd5bce5c1c6e413	NAIRLENE	12633078944	NULL	12633078944	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1760	0.0040	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	f65f553befc0e3bc8bd5bce5c1c6e413	NAIRLENE	12633078944	NULL	12633078944	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1760	0.0040	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	f65f553befc0e3bc8bd5bce5c1c6e413	NAIRLENE	12633078944	NULL	12633078944	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1760	0.0040	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	f65f553befc0e3bc8bd5bce5c1c6e413	NAIRLENE	12633078944	NULL	12633078944	07269	DIPIRONA 500 MG/ML 2 ML SI IV IM AP	0.6900	0.6867	0.0033	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	f93cee6f501560245a8f94ffc5c6c246	ROSEDALIA	12622895145	NULL	12622895145	19160	SERINGA DESC 20 ML UN	0.5400	0.5373	0.0027	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	f93cee6f501560245a8f94ffc5c6c246	ROSEDALIA	12622895145	NULL	12622895145	19160	SERINGA DESC 20 ML UN	0.5400	0.5373	0.0027	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	026c6dcfddc3d74250c79f449289696a	SALOMAO	12456038443	NULL	12456038443	12262	ISOSSORBIDA 20 MG CP VO UN	0.2200	0.2150	0.0050	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	026c6dcfddc3d74250c79f449289696a	SALOMAO	12456038443	NULL	12456038443	12262	ISOSSORBIDA 20 MG CP VO UN	0.2200	0.2150	0.0050	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	d4089ccef13567fd45b16fb0b60685fa	VERA	12640482546	NULL	12640482546	08664	ESPARADRAPO MICROPORE 50 X 10 CM CM	0.7700	0.7600	0.0000	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	d4089ccef13567fd45b16fb0b60685fa	VERA	12640482546	NULL	12640482546	27480	CLARITROMICINA 500 MG 30 ML PO IV FA	117.1100	117.1050	0.0050	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	d4089ccef13567fd45b16fb0b60685fa	VERA	12640482546	NULL	12640482546	27480	CLARITROMICINA 500 MG 30 ML PO IV FA	117.1100	117.1050	0.0050	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	d4089ccef13567fd45b16fb0b60685fa	VERA	12640482546	NULL	12640482546	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1754	0.0046	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	d4089ccef13567fd45b16fb0b60685fa	VERA	12640482546	NULL	12640482546	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1754	0.0046	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	d4089ccef13567fd45b16fb0b60685fa	VERA	12640482546	NULL	12640482546	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1754	0.0046	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	d4089ccef13567fd45b16fb0b60685fa	VERA	12640482546	NULL	12640482546	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1754	0.0046	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	eecb3d883747b059c3fe231c34567476	AFFRIDES	12693180144	NULL	12693180144	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4074	0.0026	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	eecb3d883747b059c3fe231c34567476	AFFRIDES	12693180144	NULL	12693180144	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4074	0.0026	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	eecb3d883747b059c3fe231c34567476	AFFRIDES	12693180144	NULL	12693180144	19160	SERINGA DESC 20 ML UN	0.5400	0.5372	0.0028	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	eecb3d883747b059c3fe231c34567476	AFFRIDES	12693180144	NULL	12693180144	19160	SERINGA DESC 20 ML UN	0.5400	0.5372	0.0028	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	eecb3d883747b059c3fe231c34567476	AFFRIDES	12693180144	NULL	12693180144	19160	SERINGA DESC 20 ML UN	0.5400	0.5372	0.0028	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	eecb3d883747b059c3fe231c34567476	AFFRIDES	12693180144	NULL	12693180144	19160	SERINGA DESC 20 ML UN	0.5400	0.5372	0.0028	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	eecb3d883747b059c3fe231c34567476	AFFRIDES	12693180144	NULL	12693180144	19160	SERINGA DESC 20 ML UN	0.5400	0.5372	0.0028	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1d6bbb4a00130e2e654e830fc9bae6a	ALEXANDRINA	12694224940	NULL	12694224940	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4076	0.0024	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1d6bbb4a00130e2e654e830fc9bae6a	ALEXANDRINA	12694224940	NULL	12694224940	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4072	0.0028	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1d6bbb4a00130e2e654e830fc9bae6a	ALEXANDRINA	12694224940	NULL	12694224940	19160	SERINGA DESC 20 ML UN	0.5400	0.5367	0.0033	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1d6bbb4a00130e2e654e830fc9bae6a	ALEXANDRINA	12694224940	NULL	12694224940	19160	SERINGA DESC 20 ML UN	0.5400	0.5367	0.0033	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	345c226bfea274af1372d41b0305a6c8	ALTINO	12720257940	NULL	12720257940	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.1000	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.1038	-0.0038	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.1038	-0.0038	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.1038	-0.0038	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.1038	-0.0038	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.1038	-0.0038	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.1038	-0.0038	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.1038	-0.0038	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	19160	SERINGA DESC 20 ML UN	0.5400	0.5378	0.0022	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	19160	SERINGA DESC 20 ML UN	0.5400	0.5378	0.0022	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	19160	SERINGA DESC 20 ML UN	0.5400	0.5378	0.0022	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	19160	SERINGA DESC 20 ML UN	0.5400	0.5378	0.0022	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1797	0.0003	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1797	0.0003	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1900	0.1797	0.0103	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	00426	AGUA BIDESTILADA 10 ML SI IV IM AP	0.4000	0.4045	-0.0045	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	00426	AGUA BIDESTILADA 10 ML SI IV IM AP	0.4000	0.4045	-0.0045	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	00426	AGUA BIDESTILADA 10 ML SI IV IM AP	0.8100	0.8091	0.0009	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	00426	AGUA BIDESTILADA 10 ML SI IV IM AP	0.8100	0.8091	0.0009	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	08435	EQUIPO P/ BOMBA DE INFUSAO ENTERAL / PARENT	20.2800	20.2780	0.0020	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	20567	SORO FISIOLOGICO 0,9% 500 ML SI IV BS	4.7300	4.7350	-0.0050	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	670141098c0309ac9be3db204bdc12cf	LEOSINA	12706525442	NULL	12706525442	02461	FENOTEROL 2 MG/ML 10 ML AE IN DS	0.4300	0.4250	0.0050	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	20cbe2e07b1dcd2b6af609a50df7ae80	LUCELENA	12690767849	NULL	12690767849	32891	EQUIPO POLIFIX 2ş VIAS UN	5.1000	0.0000	5.1000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	20cbe2e07b1dcd2b6af609a50df7ae80	LUCELENA	12690767849	NULL	12690767849	27480	CLARITROMICINA 500 MG 30 ML PO IV FA	117.1100	117.1050	0.0050	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	20cbe2e07b1dcd2b6af609a50df7ae80	LUCELENA	12690767849	NULL	12690767849	27480	CLARITROMICINA 500 MG 30 ML PO IV FA	117.1100	117.1050	0.0050	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	20cbe2e07b1dcd2b6af609a50df7ae80	LUCELENA	12690767849	NULL	12690767849	27480	CLARITROMICINA 500 MG 30 ML PO IV FA	117.1100	117.1050	0.0050	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	20cbe2e07b1dcd2b6af609a50df7ae80	LUCELENA	12690767849	NULL	12690767849	07269	DIPIRONA 500 MG/ML 2 ML SI IV IM AP	0.6900	0.6850	0.0050	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	20cbe2e07b1dcd2b6af609a50df7ae80	LUCELENA	12690767849	NULL	12690767849	07269	DIPIRONA 500 MG/ML 2 ML SI IV IM AP	0.6900	0.6850	0.0050	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	20cbe2e07b1dcd2b6af609a50df7ae80	LUCELENA	12690767849	NULL	12690767849	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1758	0.0042	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	20cbe2e07b1dcd2b6af609a50df7ae80	LUCELENA	12690767849	NULL	12690767849	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1758	0.0042	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	20cbe2e07b1dcd2b6af609a50df7ae80	LUCELENA	12690767849	NULL	12690767849	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1758	0.0042	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	20cbe2e07b1dcd2b6af609a50df7ae80	LUCELENA	12690767849	NULL	12690767849	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1758	0.0042	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	20cbe2e07b1dcd2b6af609a50df7ae80	LUCELENA	12690767849	NULL	12690767849	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4084	0.0016	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	20cbe2e07b1dcd2b6af609a50df7ae80	LUCELENA	12690767849	NULL	12690767849	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4084	0.0016	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	20cbe2e07b1dcd2b6af609a50df7ae80	LUCELENA	12690767849	NULL	12690767849	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4084	0.0016	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	20cbe2e07b1dcd2b6af609a50df7ae80	LUCELENA	12690767849	NULL	12690767849	19160	SERINGA DESC 20 ML UN	0.5400	0.5384	0.0016	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	20cbe2e07b1dcd2b6af609a50df7ae80	LUCELENA	12690767849	NULL	12690767849	19160	SERINGA DESC 20 ML UN	0.5400	0.5384	0.0016	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	20cbe2e07b1dcd2b6af609a50df7ae80	LUCELENA	12690767849	NULL	12690767849	19160	SERINGA DESC 20 ML UN	0.5400	0.5384	0.0016	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	20cbe2e07b1dcd2b6af609a50df7ae80	LUCELENA	12690767849	NULL	12690767849	19160	SERINGA DESC 20 ML UN	0.5400	0.5384	0.0016	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	19445	CLORETO DE POTASSIO 600 MG CA VO UN	0.4900	0.4867	0.0033	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	19445	CLORETO DE POTASSIO 600 MG CA VO UN	0.4900	0.4867	0.0033	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	19445	CLORETO DE POTASSIO 600 MG CA VO UN	0.4900	0.4867	0.0033	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4075	0.0025	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4075	0.0025	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4075	0.0025	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4075	0.0025	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	07269	DIPIRONA 500 MG/ML 2 ML SI IV IM AP	0.6900	0.6865	0.0035	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	07269	DIPIRONA 500 MG/ML 2 ML SI IV IM AP	0.6900	0.6865	0.0035	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	07269	DIPIRONA 500 MG/ML 2 ML SI IV IM AP	0.6900	0.6865	0.0035	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	07269	DIPIRONA 500 MG/ML 2 ML SI IV IM AP	0.6900	0.6865	0.0035	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	07269	DIPIRONA 500 MG/ML 2 ML SI IV IM AP	0.6900	0.6865	0.0035	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	07269	DIPIRONA 500 MG/ML 2 ML SI IV IM AP	0.6900	0.6865	0.0035	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	07269	DIPIRONA 500 MG/ML 2 ML SI IV IM AP	0.6900	0.6865	0.0035	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	19160	SERINGA DESC 20 ML UN	0.5400	0.5375	0.0025	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	19160	SERINGA DESC 20 ML UN	0.5400	0.5375	0.0025	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1761	0.0039	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1769	0.0031	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1769	0.0031	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1769	0.0031	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1769	0.0031	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1769	0.0031	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1769	0.0031	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00426	AGUA BIDESTILADA 10 ML SI IV IM AP	0.8100	0.8073	0.0027	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	33227	LUVA CIRURGICA PAR UN	1.4500	1.4477	0.0023	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	19160	SERINGA DESC 20 ML UN	0.5400	0.5372	0.0028	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	19160	SERINGA DESC 20 ML UN	0.5400	0.5372	0.0028	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	19160	SERINGA DESC 20 ML UN	0.5400	0.5372	0.0028	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	19160	SERINGA DESC 20 ML UN	0.5400	0.5372	0.0028	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	19160	SERINGA DESC 20 ML UN	0.5400	0.5372	0.0028	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	19160	SERINGA DESC 20 ML UN	0.5400	0.5372	0.0028	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	19160	SERINGA DESC 20 ML UN	0.5400	0.5372	0.0028	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1779	0.0021	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1779	0.0021	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1779	0.0021	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1779	0.0021	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1779	0.0021	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1779	0.0021	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1779	0.0021	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	11193	CLOREXIDINA 2 % ST TP ML	0.5300	0.5320	-0.0020	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	08664	ESPARADRAPO MICROPORE 50 X 10 CM CM	0.2600	0.2558	0.0042	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	08664	ESPARADRAPO MICROPORE 50 X 10 CM CM	0.2600	0.2558	0.0042	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	08664	ESPARADRAPO MICROPORE 50 X 10 CM CM	0.2600	0.2558	0.0042	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	08664	ESPARADRAPO MICROPORE 50 X 10 CM CM	0.2600	0.2558	0.0042	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	08664	ESPARADRAPO MICROPORE 50 X 10 CM CM	0.2600	0.2558	0.0042	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	08664	ESPARADRAPO MICROPORE 50 X 10 CM CM	0.2600	0.2558	0.0042	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	08664	ESPARADRAPO MICROPORE 50 X 10 CM CM	0.2600	0.2558	0.0042	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	19135	SERINGA DESC 03 ML UN	0.3000	0.0000	0.3000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	19135	SERINGA DESC 03 ML UN	0.1500	0.0000	0.1500	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	19135	SERINGA DESC 03 ML UN	0.1500	0.0000	0.1500	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	19135	SERINGA DESC 03 ML UN	0.1500	0.0000	0.1500	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	19135	SERINGA DESC 03 ML UN	0.1500	0.0000	0.1500	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	6ccea6ac8c216c032723aee73a9f81c9	PRISCILA	12662249242	NULL	12662249242	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.3500	0.3400	0.0000	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	6ccea6ac8c216c032723aee73a9f81c9	PRISCILA	12662249242	NULL	12662249242	20672	SORO RINGER SIMPLES 500 ML SI IV BS	5.9400	5.9375	0.0025	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	6ccea6ac8c216c032723aee73a9f81c9	PRISCILA	12662249242	NULL	12662249242	19160	SERINGA DESC 20 ML UN	0.5400	0.5373	0.0027	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	6ccea6ac8c216c032723aee73a9f81c9	PRISCILA	12662249242	NULL	12662249242	19160	SERINGA DESC 20 ML UN	0.5400	0.5373	0.0027	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	6ccea6ac8c216c032723aee73a9f81c9	PRISCILA	12662249242	NULL	12662249242	19160	SERINGA DESC 20 ML UN	0.5400	0.5373	0.0027	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	6ccea6ac8c216c032723aee73a9f81c9	PRISCILA	12662249242	NULL	12662249242	19160	SERINGA DESC 20 ML UN	0.5400	0.5373	0.0027	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.1000	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.1000	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.1000	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.1000	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.1000	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.1000	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.1000	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.1000	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.1000	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00426	AGUA BIDESTILADA 10 ML SI IV IM AP	1.2100	0.0000	1.2100	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00426	AGUA BIDESTILADA 10 ML SI IV IM AP	1.6200	0.0000	1.6200	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	33227	LUVA CIRURGICA PAR UN	1.4500	1.4476	0.0024	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	33227	LUVA CIRURGICA PAR UN	1.4500	1.4476	0.0024	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	33227	LUVA CIRURGICA PAR UN	1.4500	1.4476	0.0024	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	19160	SERINGA DESC 20 ML UN	0.5400	0.5384	0.0016	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	19160	SERINGA DESC 20 ML UN	0.5400	0.5384	0.0016	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	19160	SERINGA DESC 20 ML UN	0.5400	0.5384	0.0016	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	32891	EQUIPO POLIFIX 2ş VIAS UN	2.5500	2.5500	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1776	0.0024	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1776	0.0024	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1776	0.0024	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	6799aa3de305405ab065aad5b599765c	VANIR	12700232345	NULL	12700232345	07269	DIPIRONA 500 MG/ML 2 ML SI IV IM AP	0.6900	0.6870	0.0030	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	05975	COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER	0.6000	0.6000	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	29661	NOREPINEFRINA 2 MG/ML 4 ML SI IV AP	37.9900	37.9850	0.0050	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	29661	NOREPINEFRINA 2 MG/ML 4 ML SI IV AP	151.9400	151.9400	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00426	AGUA BIDESTILADA 10 ML SI IV IM AP	0.8100	0.8079	0.0021	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00426	AGUA BIDESTILADA 10 ML SI IV IM AP	0.8100	0.8079	0.0021	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00426	AGUA BIDESTILADA 10 ML SI IV IM AP	0.8100	0.8079	0.0021	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00426	AGUA BIDESTILADA 10 ML SI IV IM AP	0.8100	0.8079	0.0021	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00426	AGUA BIDESTILADA 10 ML SI IV IM AP	0.8100	0.8079	0.0021	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00426	AGUA BIDESTILADA 10 ML SI IV IM AP	0.8100	0.8079	0.0021	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	08435	EQUIPO P/ BOMBA DE INFUSAO ENTERAL / PARENT	20.2800	20.2775	0.0025	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	75bcd473a0dc7c7a6751499b38a4a034	JOAQUIM	12692852143	NULL	12692852143	53660	EQUIPO MACRO-GOTAS FLEXIVEL C/ INJETOR LATE	1.5900	1.5900	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	610c198ec4c064687cf0524f147d3aed	ROBERTO	12748814743	NULL	12748814743	19143	SERINGA DESC 05 ML UN	0.7700	0.7680	0.0020	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	610c198ec4c064687cf0524f147d3aed	ROBERTO	12748814743	NULL	12748814743	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1767	0.0033	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	610c198ec4c064687cf0524f147d3aed	ROBERTO	12748814743	NULL	12748814743	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1767	0.0033	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	610c198ec4c064687cf0524f147d3aed	ROBERTO	12748814743	NULL	12748814743	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1767	0.0033	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	610c198ec4c064687cf0524f147d3aed	ROBERTO	12748814743	NULL	12748814743	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4083	0.0017	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	610c198ec4c064687cf0524f147d3aed	ROBERTO	12748814743	NULL	12748814743	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4083	0.0017	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	610c198ec4c064687cf0524f147d3aed	ROBERTO	12748814743	NULL	12748814743	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4083	0.0017	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	610c198ec4c064687cf0524f147d3aed	ROBERTO	12748814743	NULL	12748814743	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4083	0.0017	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	610c198ec4c064687cf0524f147d3aed	ROBERTO	12748814743	NULL	12748814743	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4083	0.0017	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	610c198ec4c064687cf0524f147d3aed	ROBERTO	12748814743	NULL	12748814743	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4083	0.0017	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12647284040	NULL	12647284040	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1750	0.0050	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12647284040	NULL	12647284040	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4086	0.0014	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	08435	EQUIPO P/ BOMBA DE INFUSAO ENTERAL / PARENT	20.2800	20.2775	0.0025	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	33545	PIPERACILINA 4 G + TAZOBACTAM 500 MG PO IV	83.4500	83.4500	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	33545	PIPERACILINA 4 G + TAZOBACTAM 500 MG PO IV	83.4500	83.4500	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	33545	PIPERACILINA 4 G + TAZOBACTAM 500 MG PO IV	83.4500	83.4500	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	33545	PIPERACILINA 4 G + TAZOBACTAM 500 MG PO IV	83.4500	83.4500	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	33545	PIPERACILINA 4 G + TAZOBACTAM 500 MG PO IV	83.4500	83.4500	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	33545	PIPERACILINA 4 G + TAZOBACTAM 500 MG PO IV	83.4500	83.4500	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	6.8145	-3.4045	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	6.8145	-3.4045	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	6.8145	-3.4045	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	6.8145	-3.4045	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	6.8145	-3.4045	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4072	0.0028	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4072	0.0028	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4072	0.0028	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4072	0.0028	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4072	0.0028	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	33227	LUVA CIRURGICA PAR UN	2.9000	2.9000	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.2120	-0.1120	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.2120	-0.1120	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.2120	-0.1120	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	19160	SERINGA DESC 20 ML UN	0.5400	0.5374	0.0026	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	19160	SERINGA DESC 20 ML UN	0.5400	0.5374	0.0026	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	19160	SERINGA DESC 20 ML UN	0.5400	0.5374	0.0026	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	19160	SERINGA DESC 20 ML UN	0.5400	0.5374	0.0026	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	19160	SERINGA DESC 20 ML UN	0.5400	0.5374	0.0026	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	19160	SERINGA DESC 20 ML UN	0.5400	0.5374	0.0026	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	19160	SERINGA DESC 20 ML UN	0.5400	0.5374	0.0026	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	19160	SERINGA DESC 20 ML UN	0.5400	0.5374	0.0026	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00426	AGUA BIDESTILADA 10 ML SI IV IM AP	0.4000	0.4037	-0.0037	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00426	AGUA BIDESTILADA 10 ML SI IV IM AP	0.4000	0.4037	-0.0037	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00426	AGUA BIDESTILADA 10 ML SI IV IM AP	0.4000	0.4037	-0.0037	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00426	AGUA BIDESTILADA 10 ML SI IV IM AP	0.4000	0.4037	-0.0037	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00426	AGUA BIDESTILADA 10 ML SI IV IM AP	0.8100	0.8073	0.0027	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00426	AGUA BIDESTILADA 10 ML SI IV IM AP	0.8100	0.8073	0.0027	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00426	AGUA BIDESTILADA 10 ML SI IV IM AP	0.8100	0.8073	0.0027	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00426	AGUA BIDESTILADA 10 ML SI IV IM AP	0.8100	0.8073	0.0027	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	33219	LUVA DE PROCEDIMENTO UNIDADE UN	1.3300	1.3400	-0.0100	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	33219	LUVA DE PROCEDIMENTO UNIDADE UN	1.3300	1.3400	-0.0100	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	09636	FLORATIL (SACCHAROMYCES BOULARDII) 200 MG P	4.4400	8.8851	-4.4451	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	09636	FLORATIL (SACCHAROMYCES BOULARDII) 200 MG P	4.4400	8.8851	-4.4451	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	09636	FLORATIL (SACCHAROMYCES BOULARDII) 200 MG P	4.4400	8.8851	-4.4451	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	09636	FLORATIL (SACCHAROMYCES BOULARDII) 200 MG P	4.4400	8.8851	-4.4451	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	27600	ONDANSETRONA 2 MG/ML 4 ML SI IM IV AP	81.1800	94.7100	-81.1800	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	27600	ONDANSETRONA 2 MG/ML 4 ML SI IM IV AP	81.1800	94.7100	-81.1800	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	05975	COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER	0.8039	0.8369	-0.7769	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	05975	COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER	1.3439	1.3948	-0.7948	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	28959	DERSANI LC TP ML	5.8200	6.7900	-4.8500	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	08664	ESPARADRAPO MICROPORE 50 X 10 CM CM	1.1064	1.1285	-0.8685	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	08664	ESPARADRAPO MICROPORE 50 X 10 CM CM	1.1064	1.1285	-0.8685	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	08664	ESPARADRAPO MICROPORE 50 X 10 CM CM	1.3564	1.3849	-0.8749	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	08664	ESPARADRAPO MICROPORE 50 X 10 CM CM	1.3564	1.3849	-0.8749	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	08664	ESPARADRAPO MICROPORE 50 X 10 CM CM	1.3564	1.3849	-0.8749	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1d6bbb4a00130e2e654e830fc9bae6a	ALEXANDRINA	12694224940	NULL	12694224940	05274	AMOXICILINA 500 MG + CLAVULANATO 125 MG CP	3.1700	3.1666	0.0033	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1d6bbb4a00130e2e654e830fc9bae6a	ALEXANDRINA	12694224940	NULL	12694224940	05274	AMOXICILINA 500 MG + CLAVULANATO 125 MG CP	3.1700	3.1667	0.0033	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	03280	CLOREXIDINA 2 % ST TP ML	NULL	0.0000	NULL	OPME INVALIDO	2201
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	03280	CLOREXIDINA 2 % ST TP ML	NULL	0.0000	NULL	OPME INVALIDO	2201
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	03280	CLOREXIDINA 2 % ST TP ML	NULL	0.0000	NULL	OPME INVALIDO	2201
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	52733	SERINGA DESC 20 ML UN	NULL	0.0000	NULL	OPME INVALIDO	2201
Glosa Min	2018-10-03 00:00:00.000000	1084117	800720d33fe0defb6121e82dd216d044	JALMO	12786952647	NULL	12786952647	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1800	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	800720d33fe0defb6121e82dd216d044	JALMO	12786952647	NULL	12786952647	00757	CEFUROXIMA 750 MG + DIL. 6 ML PO IM IV FA	0.0000	26.1300	NULL	VALOR APRESENTADO A MAIOR	1705
Glosa Min	2018-10-03 00:00:00.000000	1084117	800720d33fe0defb6121e82dd216d044	JALMO	12786952647	NULL	12786952647	00757	CEFUROXIMA 750 MG + DIL. 6 ML PO IM IV FA	0.0000	26.1300	NULL	VALOR APRESENTADO A MAIOR	1705
Glosa Min	2018-10-03 00:00:00.000000	1084117	800720d33fe0defb6121e82dd216d044	JALMO	12786952647	NULL	12786952647	00090	SERINGA DESC 20 ML UN	0.0000	0.5400	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	752c651cb4fd049e19c685f87fbe8bdc	EDUARDO	12765990646	NULL	12765990646	25030019	Distúrbios Circulatórios Artério - Venosos e Linfáticos	0.0000	57.3200	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	752c651cb4fd049e19c685f87fbe8bdc	EDUARDO	12765990646	NULL	12765990646	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.0000	0.6875	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	752c651cb4fd049e19c685f87fbe8bdc	EDUARDO	12765990646	NULL	12765990646	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.0000	0.6875	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	752c651cb4fd049e19c685f87fbe8bdc	EDUARDO	12765990646	NULL	12765990646	51241	AGULHA 123X45	0.0000	0.1900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	752c651cb4fd049e19c685f87fbe8bdc	EDUARDO	12765990646	NULL	12765990646	53975	Hemifumarato De Quetiapina 25mg ? Cp	0.0000	1.2450	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	752c651cb4fd049e19c685f87fbe8bdc	EDUARDO	12765990646	NULL	12765990646	53975	Hemifumarato De Quetiapina 25mg ? Cp	0.0000	1.2450	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12558131243	NULL	12558131243	52010341	Hérnia Discal - Tratamento Cirúrgico	0.0000	0.0000	NULL	COBRANCA DE HONORARIOS EM DUPLICIDADE	2607
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12558131243	NULL	12558131243	55193	Beriplast P Selant De Fibrina 1 Ml Po Ou Fr	0.0000	1125.8740	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	526685c1041cc1316e874a2e95e67e2e	JOSE	12696604949	NULL	12696604949	00172	SORO FISIOLOGICO 0,9% 500 ML SI IV BS	0.0000	4.7300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	11232	CLEXANE (ENOXAPARINA) 40 MG SI IV SC SE	0.0000	38.9400	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	11232	CLEXANE (ENOXAPARINA) 40 MG SI IV SC SE	0.0000	38.9400	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	11700	EQUIPO P/ BOMBA DE INFUSAO ENTERAL / PARENTERAL	0.0000	0.0000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	11700	EQUIPO P/ BOMBA DE INFUSAO ENTERAL / PARENTERAL	0.0000	0.0000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	11700	EQUIPO P/ BOMBA DE INFUSAO ENTERAL / PARENTERAL	0.0000	20.2800	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	11700	EQUIPO P/ BOMBA DE INFUSAO ENTERAL / PARENTERAL	0.0000	20.2800	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.0000	0.0000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.0000	0.4000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.0000	0.4000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.0000	0.4000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.0000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	51379	SERINGA DESC 05 ML UN	0.0000	0.1900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	51379	SERINGA DESC 05 ML UN	0.0000	0.1900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	51434	BECLOMETASONA 400 MCG / ML 2 ML SL IN FL	0.0000	4.4800	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	51434	BECLOMETASONA 400 MCG / ML 2 ML SL IN FL	0.0000	4.4800	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	51660	BROMETO DE IPRATROPIO SL IN GT	0.0000	0.0000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00613	CLINDAMICINA 600 MG 4 ML SI IM IV AP	0.0000	13.0800	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00943	EQUIPO POLIFIX 2 VIAS UN	0.0000	5.1000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	4e13adf421809cb755e1bdd80cc4efed	AGRIPINA	12385409142	NULL	12385409142	39040259	Revascularização Arterial de Membro Superior Qualquer Tipo	0.0000	0.0900	NULL	COBRANCA DE HONORARIOS EM DUPLICIDADE	2607
Glosa Min	2018-10-03 00:00:00.000000	1084117	75bcd473a0dc7c7a6751499b38a4a034	JOAQUIM	12692852143	NULL	12692852143	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4075	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	75bcd473a0dc7c7a6751499b38a4a034	JOAQUIM	12692852143	NULL	12692852143	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4075	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	75bcd473a0dc7c7a6751499b38a4a034	JOAQUIM	12692852143	NULL	12692852143	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	75bcd473a0dc7c7a6751499b38a4a034	JOAQUIM	12692852143	NULL	12692852143	25040014	Fisioterapia Respiratória - em Doente Clínico Internado	0.0000	30.1700	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	75bcd473a0dc7c7a6751499b38a4a034	JOAQUIM	12692852143	NULL	12692852143	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	75bcd473a0dc7c7a6751499b38a4a034	JOAQUIM	12692852143	NULL	12692852143	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.0000	0.6850	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	75bcd473a0dc7c7a6751499b38a4a034	JOAQUIM	12692852143	NULL	12692852143	04073	TRAMADOL 50 MG 1 ML SI IM IV AP	0.0000	4.1900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	75bcd473a0dc7c7a6751499b38a4a034	JOAQUIM	12692852143	NULL	12692852143	04073	TRAMADOL 50 MG 1 ML SI IM IV AP	0.0000	4.1900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	75bcd473a0dc7c7a6751499b38a4a034	JOAQUIM	12692852143	NULL	12692852143	51710	CLORETO DE POTASSIO 15% 10 ML SI IV AP	0.0000	0.6900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00124	LUVA CIRURGICA UN	0.0000	1.4475	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00124	LUVA CIRURGICA UN	0.0000	1.4475	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00124	LUVA CIRURGICA UN	0.0000	1.4475	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00124	LUVA CIRURGICA UN	0.0000	1.4475	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	24082	BROMOPRIDA 5 MG/ML 2 ML SI IM IV AP	0.0000	2.7300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	26981	SORO FISIOLOGICO 0,9% 10 ML SI IV AP	0.0000	0.4800	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.0000	0.6875	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.0000	0.6875	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00487	RANITIDINA 25 MG/ML 2 ML SI IM IV AP	0.0000	0.9300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00487	RANITIDINA 25 MG/ML 2 ML SI IM IV AP	0.0000	0.9300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00487	RANITIDINA 25 MG/ML 2 ML SI IM IV AP	0.0000	0.9300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00487	RANITIDINA 25 MG/ML 2 ML SI IM IV AP	0.0000	0.9300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00487	RANITIDINA 25 MG/ML 2 ML SI IM IV AP	0.0000	0.9300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	51578	Frasco p/ alimentacao enteral	0.0000	2.4700	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	51578	Frasco p/ alimentacao enteral	0.0000	2.4700	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	51578	Frasco p/ alimentacao enteral	0.0000	2.4700	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	51584	ESPARADRAPO MICROPORE	0.0000	0.2560	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	51584	ESPARADRAPO MICROPORE	0.0000	0.2600	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	51584	ESPARADRAPO MICROPORE	0.0000	0.2560	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	54756	HIDANTAL	0.0000	0.1864	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	54756	HIDANTAL	0.0000	0.1864	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	55795	FOSFATO DE POTASSIO 2 MEQ/ML 10 ML SI IV AP	0.0000	3.0200	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00069	SERINGA DESC 10 ML UN	0.0000	0.9975	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00796	FLORATIL (SACCHAROMYCES BOULARDII) 200 MG PO VO	0.0000	4.4400	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4088	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4088	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4088	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4088	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4088	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4088	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4088	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4088	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4088	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4088	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4088	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4088	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4088	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4088	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.0000	0.6872	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.0000	0.6872	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.0000	0.6872	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.0000	0.6872	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	51040204	Sinusectomia (Maxilar, Etmoidal ou Esfenoidal) Endoscópica ou por Microscopia, Via Endonasal	0.0000	0.0000	NULL	EXAME SEM REGISTRO DE EXECUCAO	2703
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.0000	1.4591	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.0000	6.4600	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1766	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1766	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1766	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4070	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4070	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	22421	PIPERACILINA 2 G + TAZOBACTAM 250 MG 30 ML PO IV	0.0000	55.3400	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	02246	HIDROCORTISONA 100 MG PO IM IV FA	0.0000	8.5000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.0000	0.4000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	51584	ESPARADRAPO MICROPORE	0.0000	0.2560	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	52303	NOREPINEFRINA 2 MG/ML 4 ML SI IV AP	0.0000	94.9600	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	52303	NOREPINEFRINA 2 MG/ML 4 ML SI IV AP	0.0000	28.4900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	cd2840524be5a3f1d0939f241e24f32b	MARIA	12705908340	NULL	12705908340	101001	DIARIA DE ENFERMARIA	0.0000	173.3200	NULL	EXAME SEM REGISTRO DE EXECUCAO	2703
Glosa Min	2018-10-03 00:00:00.000000	1084117	cd2840524be5a3f1d0939f241e24f32b	MARIA	12705908340	NULL	12705908340	00184	CLORETO DE POTASSIO 10% 10 ML SI IV AP	0.0000	0.2964	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	cd2840524be5a3f1d0939f241e24f32b	MARIA	12705908340	NULL	12705908340	00184	CLORETO DE POTASSIO 10% 10 ML SI IV AP	0.0000	0.2967	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	cd2840524be5a3f1d0939f241e24f32b	MARIA	12705908340	NULL	12705908340	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	cd2840524be5a3f1d0939f241e24f32b	MARIA	12705908340	NULL	12705908340	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	cd2840524be5a3f1d0939f241e24f32b	MARIA	12705908340	NULL	12705908340	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12550571048	NULL	12550571048	00090	SERINGA DESC 20 ML UN	0.0000	0.5383	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12550571048	NULL	12550571048	00090	SERINGA DESC 20 ML UN	0.0000	0.5379	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12550571048	NULL	12550571048	00090	SERINGA DESC 20 ML UN	0.0000	0.5379	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12550571048	NULL	12550571048	00090	SERINGA DESC 20 ML UN	0.0000	0.5379	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	15d5767e884047dd75e619035a17061a	JUSCELINO	12768581943	NULL	12768581943	000445	TAXA DE TRANSPORTE E INSTALACAO DE EQUIPAMENTO DE	0.0000	0.0100	NULL	TAXA / ALUGUEL INVALIDO	2401
Glosa Min	2018-10-03 00:00:00.000000	1084117	9ffbbf7340bbd65e9e3baa9406d027f3	MARCO	12261811645	NULL	12261811645	101001	DIARIA DE ENFERMARIA	0.0000	173.3200	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	9ffbbf7340bbd65e9e3baa9406d027f3	MARCO	12261811645	NULL	12261811645	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	9ffbbf7340bbd65e9e3baa9406d027f3	MARCO	12261811645	NULL	12261811645	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	9ffbbf7340bbd65e9e3baa9406d027f3	MARCO	12261811645	NULL	12261811645	01611	CLORETO DE POTASSIO 600 MG CA VO UN	0.0000	0.4861	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	9ffbbf7340bbd65e9e3baa9406d027f3	MARCO	12261811645	NULL	12261811645	01611	CLORETO DE POTASSIO 600 MG CA VO UN	0.0000	0.4867	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	9ffbbf7340bbd65e9e3baa9406d027f3	MARCO	12261811645	NULL	12261811645	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.0000	0.8078	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	9ffbbf7340bbd65e9e3baa9406d027f3	MARCO	12261811645	NULL	12261811645	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.0000	0.8078	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	9ffbbf7340bbd65e9e3baa9406d027f3	MARCO	12261811645	NULL	12261811645	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.0000	0.8078	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	9ffbbf7340bbd65e9e3baa9406d027f3	MARCO	12261811645	NULL	12261811645	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1800	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	9ffbbf7340bbd65e9e3baa9406d027f3	MARCO	12261811645	NULL	12261811645	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1773	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	9ffbbf7340bbd65e9e3baa9406d027f3	MARCO	12261811645	NULL	12261811645	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1773	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	9ffbbf7340bbd65e9e3baa9406d027f3	MARCO	12261811645	NULL	12261811645	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1773	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	9ffbbf7340bbd65e9e3baa9406d027f3	MARCO	12261811645	NULL	12261811645	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1773	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	9ffbbf7340bbd65e9e3baa9406d027f3	MARCO	12261811645	NULL	12261811645	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1773	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	9ffbbf7340bbd65e9e3baa9406d027f3	MARCO	12261811645	NULL	12261811645	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1773	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	9ffbbf7340bbd65e9e3baa9406d027f3	MARCO	12261811645	NULL	12261811645	00090	SERINGA DESC 20 ML UN	0.0000	0.5376	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4094	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4094	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4094	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4094	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4094	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	01496	FENITOINA 50 MG/ML 5 ML SI IM IV AP	0.0000	2.3400	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	02246	HIDROCORTISONA 100 MG PO IM IV FA	0.0000	2.8300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	26981	SORO FISIOLOGICO 0,9% 10 ML SI IV AP	0.0000	0.4800	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	26981	SORO FISIOLOGICO 0,9% 10 ML SI IV AP	0.0000	0.4800	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	26981	SORO FISIOLOGICO 0,9% 10 ML SI IV AP	0.0000	0.4800	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	26981	SORO FISIOLOGICO 0,9% 10 ML SI IV AP	0.0000	0.9600	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	26981	SORO FISIOLOGICO 0,9% 10 ML SI IV AP	0.0000	0.9600	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	26981	SORO FISIOLOGICO 0,9% 10 ML SI IV AP	0.0000	0.9600	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	26981	SORO FISIOLOGICO 0,9% 10 ML SI IV AP	0.0000	0.9600	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	26981	SORO FISIOLOGICO 0,9% 10 ML SI IV AP	0.0000	0.9600	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	26981	SORO FISIOLOGICO 0,9% 10 ML SI IV AP	0.0000	0.9600	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	26981	SORO FISIOLOGICO 0,9% 10 ML SI IV AP	0.0000	0.9600	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	26981	SORO FISIOLOGICO 0,9% 10 ML SI IV AP	0.0000	0.9600	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	26981	SORO FISIOLOGICO 0,9% 10 ML SI IV AP	0.0000	0.9600	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	26981	SORO FISIOLOGICO 0,9% 10 ML SI IV AP	0.0000	0.9600	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	26981	SORO FISIOLOGICO 0,9% 10 ML SI IV AP	0.0000	0.9600	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	09070	ACETILCISTEINA 600MG PO VO SA	0.0000	3.4950	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	09070	ACETILCISTEINA 600MG PO VO SA	0.0000	3.4950	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	09070	ACETILCISTEINA 600MG PO VO SA	0.0000	3.4950	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	09070	ACETILCISTEINA 600MG PO VO SA	0.0000	3.5000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	00091	SERINGA DESC 01 ML (INSULINA) UN	0.0000	0.3100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	00091	SERINGA DESC 01 ML (INSULINA) UN	0.0000	0.3100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	15f461c0ca379f375bd9f8b18fbb101a	ANA	12753753845	NULL	12753753845	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR APRESENTADO A MAIOR	1705
Glosa Min	2018-10-03 00:00:00.000000	1084117	15f461c0ca379f375bd9f8b18fbb101a	ANA	12753753845	NULL	12753753845	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.0000	0.8100	NULL	VALOR APRESENTADO A MAIOR	1705
Glosa Min	2018-10-03 00:00:00.000000	1084117	15f461c0ca379f375bd9f8b18fbb101a	ANA	12753753845	NULL	12753753845	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1771	NULL	VALOR APRESENTADO A MAIOR	1705
Glosa Min	2018-10-03 00:00:00.000000	1084117	15f461c0ca379f375bd9f8b18fbb101a	ANA	12753753845	NULL	12753753845	55279	TRAMADOL 50 MG 1 ML SI IM IV AP	0.0000	4.1900	NULL	COBRANCA DE MEDICAMENTO INCOMPATIVEL COM O RELATORIO TECNICO	2112
Glosa Min	2018-10-03 00:00:00.000000	1084117	15f461c0ca379f375bd9f8b18fbb101a	ANA	12753753845	NULL	12753753845	55279	TRAMADOL 50 MG 1 ML SI IM IV AP	0.0000	4.1900	NULL	COBRANCA DE MEDICAMENTO INCOMPATIVEL COM O RELATORIO TECNICO	2112
Glosa Min	2018-10-03 00:00:00.000000	1084117	15f461c0ca379f375bd9f8b18fbb101a	ANA	12753753845	NULL	12753753845	55279	TRAMADOL 50 MG 1 ML SI IM IV AP	0.0000	4.1900	NULL	COBRANCA DE MEDICAMENTO INCOMPATIVEL COM O RELATORIO TECNICO	2112
Glosa Min	2018-10-03 00:00:00.000000	1084117	15f461c0ca379f375bd9f8b18fbb101a	ANA	12753753845	NULL	12753753845	00657	CEFAZOLINA 1 GR + DIL. 10 ML PO IM IV FA	0.0000	8.1300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	15f461c0ca379f375bd9f8b18fbb101a	ANA	12753753845	NULL	12753753845	00657	CEFAZOLINA 1 GR + DIL. 10 ML PO IM IV FA	0.0000	16.2600	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4072	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4072	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4072	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4072	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4072	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4072	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4072	NULL	COBRANCA DE MEDICAMENTO EM QUANTIDADE INCOMPATIVEL COM A PERMANENCIA	2107
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4072	NULL	COBRANCA DE MEDICAMENTO EM QUANTIDADE INCOMPATIVEL COM A PERMANENCIA	2107
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4072	NULL	VALOR APRESENTADO A MAIOR	1705
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4072	NULL	VALOR APRESENTADO A MAIOR	1705
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4072	NULL	VALOR APRESENTADO A MAIOR	1705
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	02355	AMOXICILINA 1 G + CLAVULANATO 200 MG + DIL. 10 ML	0.0000	36.4667	NULL	COBRANCA DE MEDICAMENTO EM QUANTIDADE INCOMPATIVEL COM A PERMANENCIA	2107
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	02355	AMOXICILINA 1 G + CLAVULANATO 200 MG + DIL. 10 ML	0.0000	36.4667	NULL	COBRANCA DE MEDICAMENTO EM QUANTIDADE INCOMPATIVEL COM A PERMANENCIA	2107
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	02355	AMOXICILINA 1 G + CLAVULANATO 200 MG + DIL. 10 ML	0.0000	36.4667	NULL	COBRANCA DE MEDICAMENTO EM QUANTIDADE INCOMPATIVEL COM A PERMANENCIA	2107
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	02355	AMOXICILINA 1 G + CLAVULANATO 200 MG + DIL. 10 ML	0.0000	36.4667	NULL	COBRANCA DE MEDICAMENTO EM QUANTIDADE INCOMPATIVEL COM A PERMANENCIA	2107
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	02355	AMOXICILINA 1 G + CLAVULANATO 200 MG + DIL. 10 ML	0.0000	36.4667	NULL	COBRANCA DE MEDICAMENTO EM QUANTIDADE INCOMPATIVEL COM A PERMANENCIA	2107
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00090	SERINGA DESC 20 ML UN	0.0000	0.5367	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00090	SERINGA DESC 20 ML UN	0.0000	0.5367	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00091	SERINGA DESC 01 ML (INSULINA) UN	0.0000	0.6100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	2e6b6f291f2df9beb1fbda6028678909	ANNA	12463693448	NULL	12463693448	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	2e6b6f291f2df9beb1fbda6028678909	ANNA	12463693448	NULL	12463693448	29020166	Nebulização Simples com Broncodilatador	0.0000	4.6800	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	2e6b6f291f2df9beb1fbda6028678909	ANNA	12463693448	NULL	12463693448	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	11325	EQUIPO MACRO-GOTAS FLEXIVEL C/ INJETOR LATERAL UN	0.0000	1.5900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00124	LUVA CIRURGICA UN	0.0000	1.4478	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00124	LUVA CIRURGICA UN	0.0000	1.4478	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00124	LUVA CIRURGICA UN	0.0000	1.4478	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00124	LUVA CIRURGICA UN	0.0000	1.4478	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00124	LUVA CIRURGICA UN	0.0000	1.4478	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.0000	0.6871	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.0000	0.6900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.0000	0.6900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	35382	COMPRESSAS DE GASES 7.5 X7,5 (11 FIOS ESTERIL) UN	0.0000	0.3000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	35382	COMPRESSAS DE GASES 7.5 X7,5 (11 FIOS ESTERIL) UN	0.0000	0.6000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00487	RANITIDINA 25 MG/ML 2 ML SI IM IV AP	0.0000	0.9300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.0000	0.4000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.0000	0.4000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.0000	0.4000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.0000	0.4000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1776	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1776	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1776	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	51649	ALCOOL ETILICO 70 % ST TP ML	0.0000	0.0300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00090	SERINGA DESC 20 ML UN	0.0000	0.5350	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00090	SERINGA DESC 20 ML UN	0.0000	0.5375	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00090	SERINGA DESC 20 ML UN	0.0000	0.5375	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00090	SERINGA DESC 20 ML UN	0.0000	0.5375	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00090	SERINGA DESC 20 ML UN	0.0000	0.5375	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00090	SERINGA DESC 20 ML UN	0.0000	0.5375	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00090	SERINGA DESC 20 ML UN	0.0000	0.5375	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00090	SERINGA DESC 20 ML UN	0.0000	0.5375	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00090	SERINGA DESC 20 ML UN	0.0000	0.5375	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00090	SERINGA DESC 20 ML UN	0.0000	0.5375	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00090	SERINGA DESC 20 ML UN	0.0000	0.5375	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00090	SERINGA DESC 20 ML UN	0.0000	0.5375	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00090	SERINGA DESC 20 ML UN	0.0000	0.5375	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	09586cdd4dbbc5a8f142ad1eff19fbe6	VALDECI	12697562440	NULL	12697562440	25040014	Fisioterapia Respiratória - em Doente Clínico Internado	0.0000	15.1000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1965b0cdebe9017c3397c8641147759	JOSE	12705413746	NULL	12705413746	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.0000	0.6900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1965b0cdebe9017c3397c8641147759	JOSE	12705413746	NULL	12705413746	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.0000	0.8074	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1965b0cdebe9017c3397c8641147759	JOSE	12705413746	NULL	12705413746	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.0000	0.8074	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1965b0cdebe9017c3397c8641147759	JOSE	12705413746	NULL	12705413746	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.0000	0.8074	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1965b0cdebe9017c3397c8641147759	JOSE	12705413746	NULL	12705413746	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1775	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1965b0cdebe9017c3397c8641147759	JOSE	12705413746	NULL	12705413746	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1775	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1965b0cdebe9017c3397c8641147759	JOSE	12705413746	NULL	12705413746	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1775	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1965b0cdebe9017c3397c8641147759	JOSE	12705413746	NULL	12705413746	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1775	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1965b0cdebe9017c3397c8641147759	JOSE	12705413746	NULL	12705413746	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1775	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1965b0cdebe9017c3397c8641147759	JOSE	12705413746	NULL	12705413746	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1775	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1965b0cdebe9017c3397c8641147759	JOSE	12705413746	NULL	12705413746	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1775	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1965b0cdebe9017c3397c8641147759	JOSE	12705413746	NULL	12705413746	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1775	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1965b0cdebe9017c3397c8641147759	JOSE	12705413746	NULL	12705413746	51584	ESPARADRAPO MICROPORE	0.0000	0.3800	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1965b0cdebe9017c3397c8641147759	JOSE	12705413746	NULL	12705413746	51584	ESPARADRAPO MICROPORE	0.0000	0.3800	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1965b0cdebe9017c3397c8641147759	JOSE	12705413746	NULL	12705413746	51584	ESPARADRAPO MICROPORE	0.0000	0.3800	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1965b0cdebe9017c3397c8641147759	JOSE	12705413746	NULL	12705413746	00090	SERINGA DESC 20 ML UN	0.0000	0.5375	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1965b0cdebe9017c3397c8641147759	JOSE	12705413746	NULL	12705413746	00090	SERINGA DESC 20 ML UN	0.0000	0.5375	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1965b0cdebe9017c3397c8641147759	JOSE	12705413746	NULL	12705413746	00090	SERINGA DESC 20 ML UN	0.0000	0.5375	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1965b0cdebe9017c3397c8641147759	JOSE	12705413746	NULL	12705413746	00090	SERINGA DESC 20 ML UN	0.0000	0.5375	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a39fe8b0276da428395df4da4f2b1537	JOSE	12442708440	NULL	12442708440	00380	SALBUTAMOL 100 MCG SY VO DS	NULL	0.0000	NULL	OPME INVALIDO	2201
Glosa Min	2018-10-03 00:00:00.000000	1084117	a39fe8b0276da428395df4da4f2b1537	JOSE	12442708440	NULL	12442708440	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a39fe8b0276da428395df4da4f2b1537	JOSE	12442708440	NULL	12442708440	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a39fe8b0276da428395df4da4f2b1537	JOSE	12442708440	NULL	12442708440	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a39fe8b0276da428395df4da4f2b1537	JOSE	12442708440	NULL	12442708440	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a39fe8b0276da428395df4da4f2b1537	JOSE	12442708440	NULL	12442708440	20691	HIDROCORTISONA 100 MG PO IM IV FA	0.0000	2.8300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a39fe8b0276da428395df4da4f2b1537	JOSE	12442708440	NULL	12442708440	26981	SORO FISIOLOGICO 0,9% 10 ML SI IV AP	0.0000	0.1400	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a39fe8b0276da428395df4da4f2b1537	JOSE	12442708440	NULL	12442708440	26981	SORO FISIOLOGICO 0,9% 10 ML SI IV AP	0.0000	0.1400	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a39fe8b0276da428395df4da4f2b1537	JOSE	12442708440	NULL	12442708440	26981	SORO FISIOLOGICO 0,9% 10 ML SI IV AP	0.0000	0.1400	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a39fe8b0276da428395df4da4f2b1537	JOSE	12442708440	NULL	12442708440	26981	SORO FISIOLOGICO 0,9% 10 ML SI IV AP	0.0000	0.4800	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a39fe8b0276da428395df4da4f2b1537	JOSE	12442708440	NULL	12442708440	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1780	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a39fe8b0276da428395df4da4f2b1537	JOSE	12442708440	NULL	12442708440	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1765	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a39fe8b0276da428395df4da4f2b1537	JOSE	12442708440	NULL	12442708440	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1765	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a39fe8b0276da428395df4da4f2b1537	JOSE	12442708440	NULL	12442708440	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1765	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a39fe8b0276da428395df4da4f2b1537	JOSE	12442708440	NULL	12442708440	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1765	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a39fe8b0276da428395df4da4f2b1537	JOSE	12442708440	NULL	12442708440	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1765	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a39fe8b0276da428395df4da4f2b1537	JOSE	12442708440	NULL	12442708440	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1765	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a39fe8b0276da428395df4da4f2b1537	JOSE	12442708440	NULL	12442708440	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1765	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a39fe8b0276da428395df4da4f2b1537	JOSE	12442708440	NULL	12442708440	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1765	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a39fe8b0276da428395df4da4f2b1537	JOSE	12442708440	NULL	12442708440	00090	SERINGA DESC 20 ML UN	0.0000	0.5373	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a39fe8b0276da428395df4da4f2b1537	JOSE	12442708440	NULL	12442708440	00098	ABOCATH N 14 A 22 UN	0.0000	3.7700	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	61e4786d45edfdbf19b77fb2c6ce6b9c	REINALDO	12754482747	NULL	12754482747	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	61e4786d45edfdbf19b77fb2c6ce6b9c	REINALDO	12754482747	NULL	12754482747	00172	SORO FISIOLOGICO 0,9% 500 ML SI IV BS	0.0000	4.7300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	61e4786d45edfdbf19b77fb2c6ce6b9c	REINALDO	12754482747	NULL	12754482747	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	61e4786d45edfdbf19b77fb2c6ce6b9c	REINALDO	12754482747	NULL	12754482747	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.0000	0.6900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	61e4786d45edfdbf19b77fb2c6ce6b9c	REINALDO	12754482747	NULL	12754482747	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.0000	0.4000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	61e4786d45edfdbf19b77fb2c6ce6b9c	REINALDO	12754482747	NULL	12754482747	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.0000	0.4000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	61e4786d45edfdbf19b77fb2c6ce6b9c	REINALDO	12754482747	NULL	12754482747	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1800	NULL	VALOR APRESENTADO A MAIOR	1705
Glosa Min	2018-10-03 00:00:00.000000	1084117	61e4786d45edfdbf19b77fb2c6ce6b9c	REINALDO	12754482747	NULL	12754482747	51649	ALCOOL ETILICO 70 % ST TP ML	0.0000	0.0300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	61e4786d45edfdbf19b77fb2c6ce6b9c	REINALDO	12754482747	NULL	12754482747	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	61e4786d45edfdbf19b77fb2c6ce6b9c	REINALDO	12754482747	NULL	12754482747	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	102001	DIARIA DE APARTAMENTO	0.0000	288.8880	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	102001	DIARIA DE APARTAMENTO	0.0000	288.8880	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4072	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4072	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4072	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4072	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4072	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4072	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4072	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	00090	SERINGA DESC 20 ML UN	0.0000	0.5371	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	00090	SERINGA DESC 20 ML UN	0.0000	0.5371	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	00090	SERINGA DESC 20 ML UN	0.0000	0.5371	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	00090	SERINGA DESC 20 ML UN	0.0000	0.5371	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	00090	SERINGA DESC 20 ML UN	0.0000	0.5371	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	00090	SERINGA DESC 20 ML UN	0.0000	0.5371	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	00090	SERINGA DESC 20 ML UN	0.0000	0.5371	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	00090	SERINGA DESC 20 ML UN	0.0000	0.5371	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	00090	SERINGA DESC 20 ML UN	0.0000	0.5371	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	00090	SERINGA DESC 20 ML UN	0.0000	0.5371	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	00090	SERINGA DESC 20 ML UN	0.0000	0.5371	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	081fdadb830fb547e83c43fabdb88372	ELZA	12377335349	NULL	12377335349	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	081fdadb830fb547e83c43fabdb88372	ELZA	12377335349	NULL	12377335349	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	081fdadb830fb547e83c43fabdb88372	ELZA	12377335349	NULL	12377335349	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	081fdadb830fb547e83c43fabdb88372	ELZA	12377335349	NULL	12377335349	01611	CLORETO DE POTASSIO 600 MG CA VO UN	0.0000	0.4900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	081fdadb830fb547e83c43fabdb88372	ELZA	12377335349	NULL	12377335349	01611	CLORETO DE POTASSIO 600 MG CA VO UN	0.0000	0.4900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	081fdadb830fb547e83c43fabdb88372	ELZA	12377335349	NULL	12377335349	02246	HIDROCORTISONA 100 MG PO IM IV FA	0.0000	5.6700	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	081fdadb830fb547e83c43fabdb88372	ELZA	12377335349	NULL	12377335349	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1800	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	081fdadb830fb547e83c43fabdb88372	ELZA	12377335349	NULL	12377335349	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1800	NULL	PAGO CONFORME RELATORIO DE AUDITORIA EXTERNA ― CONTA INICIAL	1717
Glosa Min	2018-10-03 00:00:00.000000	1084117	081fdadb830fb547e83c43fabdb88372	ELZA	12377335349	NULL	12377335349	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1800	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	081fdadb830fb547e83c43fabdb88372	ELZA	12377335349	NULL	12377335349	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1800	NULL	PAGO CONFORME RELATORIO DE AUDITORIA EXTERNA ― CONTA INICIAL	1717
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.0000	0.6860	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.0000	0.6860	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.0000	0.6860	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.0000	0.6860	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	04073	TRAMADOL 50 MG 1 ML SI IM IV AP	0.0000	4.1900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	51379	SERINGA DESC 05 ML UN	0.0000	0.1900	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	51379	SERINGA DESC 05 ML UN	0.0000	0.1900	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	51379	SERINGA DESC 05 ML UN	0.0000	0.1900	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	51379	SERINGA DESC 05 ML UN	0.0000	0.1900	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	51379	SERINGA DESC 05 ML UN	0.0000	0.1900	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	345c226bfea274af1372d41b0305a6c8	ALTINO	12720257940	NULL	12720257940	25722	OMEPRAZOL 40 MG + DIL. 10 ML PO IV FA	0.0000	0.0000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	345c226bfea274af1372d41b0305a6c8	ALTINO	12720257940	NULL	12720257940	00128	LUVA DE PROCEDIMENTO UNIDADE UN	0.0000	0.2898	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	dd486d36a88cfef0b44fe652638a0164	DELFINA	12660326244	NULL	12660326244	01003	FUROSEMIDA 40 MG CP VO UN	0.0000	0.2700	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	dd486d36a88cfef0b44fe652638a0164	DELFINA	12660326244	NULL	12660326244	01137	SONDA URETRAL N 12 UN	0.0000	0.7600	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	dd486d36a88cfef0b44fe652638a0164	DELFINA	12660326244	NULL	12660326244	00124	LUVA CIRURGICA UN	0.0000	1.4500	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	dd486d36a88cfef0b44fe652638a0164	DELFINA	12660326244	NULL	12660326244	00124	LUVA CIRURGICA UN	0.0000	1.4500	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	dd486d36a88cfef0b44fe652638a0164	DELFINA	12660326244	NULL	12660326244	00128	LUVA DE PROCEDIMENTO UNIDADE UN	0.0000	1.6700	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	dd486d36a88cfef0b44fe652638a0164	DELFINA	12660326244	NULL	12660326244	00128	LUVA DE PROCEDIMENTO UNIDADE UN	0.0000	1.6700	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	dd486d36a88cfef0b44fe652638a0164	DELFINA	12660326244	NULL	12660326244	00128	LUVA DE PROCEDIMENTO UNIDADE UN	0.0000	0.6700	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	dd486d36a88cfef0b44fe652638a0164	DELFINA	12660326244	NULL	12660326244	00128	LUVA DE PROCEDIMENTO UNIDADE UN	0.0000	1.0000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	dd486d36a88cfef0b44fe652638a0164	DELFINA	12660326244	NULL	12660326244	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	dd486d36a88cfef0b44fe652638a0164	DELFINA	12660326244	NULL	12660326244	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	dd486d36a88cfef0b44fe652638a0164	DELFINA	12660326244	NULL	12660326244	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	dd486d36a88cfef0b44fe652638a0164	DELFINA	12660326244	NULL	12660326244	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	dd486d36a88cfef0b44fe652638a0164	DELFINA	12660326244	NULL	12660326244	00090	SERINGA DESC 20 ML UN	0.0000	0.5400	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	01652	TRAMADOL 50 MG CP VO UN	0.0000	1.9300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	01652	TRAMADOL 50 MG CP VO UN	0.0000	1.9300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	01652	TRAMADOL 50 MG CP VO UN	0.0000	1.9300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	00184	CLORETO DE POTASSIO 10% 10 ML SI IV AP	0.0000	0.5900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.0000	0.6875	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.0000	0.6875	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.0000	0.6900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.0000	0.6900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	35382	COMPRESSAS DE GASES 7.5 X7,5 (11 FIOS ESTERIL) UN	0.0000	0.3000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	35382	COMPRESSAS DE GASES 7.5 X7,5 (11 FIOS ESTERIL) UN	0.0000	0.3000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1800	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1800	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1800	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	51588	ESPARADRAPO MICROPORE 50 X 10 CM CM	0.0000	0.7700	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3fb5c891f31bb9efcb05395066127c52	ALAIDE	12636273441	NULL	12636273441	00487	RANITIDINA 25 MG/ML 2 ML SI IM IV AP	0.0000	0.9300	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	610c198ec4c064687cf0524f147d3aed	ROBERTO	12748814743	NULL	12748814743	16322	BENZILPENICILINA POTASSICA CRIST. 5.000.000	8.0700	8.0683	0.0017	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	610c198ec4c064687cf0524f147d3aed	ROBERTO	12748814743	NULL	12748814743	16322	BENZILPENICILINA POTASSICA CRIST. 5.000.000	8.0700	8.0683	0.0017	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	610c198ec4c064687cf0524f147d3aed	ROBERTO	12748814743	NULL	12748814743	16322	BENZILPENICILINA POTASSICA CRIST. 5.000.000	8.0700	8.0683	0.0017	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	610c198ec4c064687cf0524f147d3aed	ROBERTO	12748814743	NULL	12748814743	16322	BENZILPENICILINA POTASSICA CRIST. 5.000.000	8.0700	8.0683	0.0017	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	610c198ec4c064687cf0524f147d3aed	ROBERTO	12748814743	NULL	12748814743	16322	BENZILPENICILINA POTASSICA CRIST. 5.000.000	8.0700	8.0685	0.0017	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	03280	CLOREXIDINA 2 % ST TP ML	0.0500	0.0200	0.0300	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	51378	SERINGA DESC 03 ML UN	0.1500	0.0600	0.0900	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	51378	SERINGA DESC 03 ML UN	0.1500	0.0600	0.0900	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	51457	LIDOCAINA 2% S/ VASO SI PE SC ML	0.2300	0.0900	0.1400	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	03280	CLOREXIDINA 2 % ST TP ML	0.2700	0.1100	0.1600	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00127	LUVA DE PROCEDIMENTO UNIDADE UN	0.3300	0.1300	0.2000	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00127	LUVA DE PROCEDIMENTO UNIDADE UN	0.3300	0.1300	0.2000	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00127	LUVA DE PROCEDIMENTO UNIDADE UN	0.3300	0.1300	0.2000	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00127	LUVA DE PROCEDIMENTO UNIDADE UN	0.3300	0.1300	0.2000	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.4000	0.1600	0.2400	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.4000	0.1600	0.2400	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.4000	0.1600	0.2400	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.4000	0.1600	0.2400	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.4000	0.1600	0.2400	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.4000	0.1600	0.2400	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	51589	ESPARADRAPO 10 X 4.5 CM CM	0.4000	0.1600	0.2400	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00090	SERINGA DESC 20 ML UN	0.5400	0.2200	0.3200	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	19400	CIPROFLOXACINO 2 MG/ML 100 ML SI IV BS	80.1700	31.3000	48.8700	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	07802	PIPERACILINA 4 G + TAZOBACTAM 500 MG PO IV FA	83.4500	32.5900	50.8600	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	07802	PIPERACILINA 4 G + TAZOBACTAM 500 MG PO IV FA	83.4500	32.5900	50.8600	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	07802	PIPERACILINA 4 G + TAZOBACTAM 500 MG PO IV FA	83.4500	32.5900	50.8600	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	07802	PIPERACILINA 4 G + TAZOBACTAM 500 MG PO IV FA	83.4500	32.5900	50.8600	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00020010	Visita Hospitalar (Paciente Internado)	131.4000	51.3100	80.0900	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	201002	TAXA DE SALA PORTE 1	198.6200	77.5600	121.0600	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	54626	CATETER VENOSO CENTRAL DUPLO LUMEN 5FRX10 A 16CM	200.0000	78.1000	121.9000	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	01081197	e0b1f77dc9cff210f2fbead99c7ba4d4	MARCIO	12790052920	NULL	12790052920	53895	OMNIPAQUE (IOEXOL) 300 MG/IML SI IT IV VO ML	NULL	0.0000	NULL	OPME INVALIDO	2201
Glosa Min	2018-10-03 00:00:00.000000	1084117	16b1e9f62f247f02ad5cac910ee15b4e	BERCHOLINA	12631612848	NULL	12631612848	04073	TRAMADOL 50 MG 1 ML SI IM IV AP	4.1900	4.0000	0.1900	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	16b1e9f62f247f02ad5cac910ee15b4e	BERCHOLINA	12631612848	NULL	12631612848	04073	TRAMADOL 50 MG 1 ML SI IM IV AP	4.1900	4.0000	0.1900	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	16b1e9f62f247f02ad5cac910ee15b4e	BERCHOLINA	12631612848	NULL	12631612848	04073	TRAMADOL 50 MG 1 ML SI IM IV AP	4.1900	3.9900	0.2000	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	16b1e9f62f247f02ad5cac910ee15b4e	BERCHOLINA	12631612848	NULL	12631612848	22421	PIPERACILINA 2 G + TAZOBACTAM 250 MG 30 ML PO IV	55.3400	52.7400	2.6000	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	16b1e9f62f247f02ad5cac910ee15b4e	BERCHOLINA	12631612848	NULL	12631612848	22421	PIPERACILINA 2 G + TAZOBACTAM 250 MG 30 ML PO IV	55.3400	52.7400	2.6000	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	16b1e9f62f247f02ad5cac910ee15b4e	BERCHOLINA	12631612848	NULL	12631612848	22421	PIPERACILINA 2 G + TAZOBACTAM 250 MG 30 ML PO IV	55.3400	52.7400	2.6000	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	16b1e9f62f247f02ad5cac910ee15b4e	BERCHOLINA	12631612848	NULL	12631612848	20080	LINEZOLIDA 2 MG/ML 300 ML SI IV BS	174.9800	166.7800	8.2000	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	16b1e9f62f247f02ad5cac910ee15b4e	BERCHOLINA	12631612848	NULL	12631612848	20080	LINEZOLIDA 2 MG/ML 300 ML SI IV BS	174.9800	166.7800	8.2000	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	16b1e9f62f247f02ad5cac910ee15b4e	BERCHOLINA	12631612848	NULL	12631612848	102001	DIARIA DE APARTAMENTO	2022.2100	1927.5200	94.6900	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12579183644	NULL	12579183644	02720	BOLSA COLETORA (SISTEMA ABERTO) UN	1.2800	0.6400	0.6400	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12579183644	NULL	12579183644	32204	CLORETO DE SODIO 0,9% 10 ML SI IV AP	0.9600	0.0000	0.9600	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12579183644	NULL	12579183644	02720	BOLSA COLETORA (SISTEMA ABERTO) UN	1.2800	0.6400	0.6400	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12579183644	NULL	12579183644	37761	ALCOOL ETILICO 70 % ST TP ML	0.0600	0.0300	0.0300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12579183644	NULL	12579183644	02720	BOLSA COLETORA (SISTEMA ABERTO) UN	1.2800	0.6400	0.6400	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12579183644	NULL	12579183644	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.3500	0.0000	0.3500	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12579183644	NULL	12579183644	28959	DERSANI LC TP ML	19.4000	14.5500	4.8500	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12579183644	NULL	12579183644	00485	AGUA BIDESTILADA 500 ML SI IM IV BS	6.4300	0.0000	6.4300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	d17b3c5ae418d82694895a326dee545a	ODILIA	12670516743	NULL	12670516743	37761	ALCOOL ETILICO 70 % ST TP ML	0.0300	0.0200	0.0100	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	d17b3c5ae418d82694895a326dee545a	ODILIA	12670516743	NULL	12670516743	37761	ALCOOL ETILICO 70 % ST TP ML	0.0300	0.0200	0.0100	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	20cbe2e07b1dcd2b6af609a50df7ae80	LUCELENA	12690767849	NULL	12690767849	37761	ALCOOL ETILICO 70 % ST TP ML	0.0600	0.0200	0.0400	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	20cbe2e07b1dcd2b6af609a50df7ae80	LUCELENA	12690767849	NULL	12690767849	00817	ALGODAO HIDROFILO BOLINHA UN	0.5100	0.1300	0.3800	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	01724	ATADURA CREPOM 10 CM UN	0.7900	0.0000	0.7900	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	32891	EQUIPO POLIFIX 2ş VIAS UN	5.1000	2.5500	2.5500	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	32891	EQUIPO POLIFIX 2ş VIAS UN	5.1000	0.0000	5.1000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	08648	ESPARADRAPO 10 X 4.5 CM CM	0.4000	0.2000	0.2000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00485	AGUA BIDESTILADA 500 ML SI IM IV BS	6.4300	0.0000	6.4300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	02720	BOLSA COLETORA (SISTEMA ABERTO) UN	1.2800	0.6400	0.6400	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	02720	BOLSA COLETORA (SISTEMA ABERTO) UN	1.2800	0.6400	0.6400	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	08648	ESPARADRAPO 10 X 4.5 CM CM	0.4000	0.2000	0.2000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	22748	LIDOCAINA 2% GE TP OU GR	2.5900	1.3000	1.2900	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	02720	BOLSA COLETORA (SISTEMA ABERTO) UN	1.2800	0.6400	0.6400	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	02720	BOLSA COLETORA (SISTEMA ABERTO) UN	1.2800	0.3200	0.9600	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00817	ALGODAO HIDROFILO BOLINHA UN	0.5100	0.2600	0.2500	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00817	ALGODAO HIDROFILO BOLINHA UN	0.5100	0.2600	0.2500	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00817	ALGODAO HIDROFILO BOLINHA UN	0.5100	0.2600	0.2500	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	33219	LUVA DE PROCEDIMENTO UNIDADE UN	0.3300	0.0000	0.3300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	37761	ALCOOL ETILICO 70 % ST TP ML	0.0600	0.0300	0.0300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	37761	ALCOOL ETILICO 70 % ST TP ML	0.0600	0.0300	0.0300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	752c651cb4fd049e19c685f87fbe8bdc	EDUARDO	12765990646	NULL	12765990646	37761	ALCOOL ETILICO 70 % ST TP ML	0.0300	0.0200	0.0100	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	752c651cb4fd049e19c685f87fbe8bdc	EDUARDO	12765990646	NULL	12765990646	18457	REPARIL (ESCINA + DIETILAMONIO) GL TP GR	5.6300	1.8800	3.7500	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	752c651cb4fd049e19c685f87fbe8bdc	EDUARDO	12765990646	NULL	12765990646	00817	ALGODAO HIDROFILO BOLINHA UN	0.5100	0.1300	0.3800	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	752c651cb4fd049e19c685f87fbe8bdc	EDUARDO	12765990646	NULL	12765990646	08435	EQUIPO P/ BOMBA DE INFUSAO ENTERAL / PARENT	40.5600	0.0000	40.5600	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	752c651cb4fd049e19c685f87fbe8bdc	EDUARDO	12765990646	NULL	12765990646	37761	ALCOOL ETILICO 70 % ST TP ML	0.0600	0.0200	0.0400	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	752c651cb4fd049e19c685f87fbe8bdc	EDUARDO	12765990646	NULL	12765990646	00817	ALGODAO HIDROFILO BOLINHA UN	0.2600	0.1300	0.1300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	02461	FENOTEROL 2 MG/ML 10 ML AE IN DS	2.5500	0.0000	2.5500	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	345c226bfea274af1372d41b0305a6c8	ALTINO	12720257940	NULL	12720257940	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.1000	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	345c226bfea274af1372d41b0305a6c8	ALTINO	12720257940	NULL	12720257940	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.1000	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	345c226bfea274af1372d41b0305a6c8	ALTINO	12720257940	NULL	12720257940	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.1000	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	345c226bfea274af1372d41b0305a6c8	ALTINO	12720257940	NULL	12720257940	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.1000	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	345c226bfea274af1372d41b0305a6c8	ALTINO	12720257940	NULL	12720257940	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.1000	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	345c226bfea274af1372d41b0305a6c8	ALTINO	12720257940	NULL	12720257940	07269	DIPIRONA 500 MG/ML 2 ML SI IV IM AP	0.6900	0.6860	0.0040	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	345c226bfea274af1372d41b0305a6c8	ALTINO	12720257940	NULL	12720257940	13404	OMEPRAZOL 40 MG + DIL. 10 ML PO IV FA	19.5800	19.5750	0.0050	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	345c226bfea274af1372d41b0305a6c8	ALTINO	12720257940	NULL	12720257940	13404	OMEPRAZOL 40 MG + DIL. 10 ML PO IV FA	19.5800	19.5750	0.0050	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	31d18d6607d9e742c53e748d6a55d740	CARLOS	12557779343	NULL	12557779343	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1760	0.0040	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	0405a686318e3fc262f105ed4be24d95	CARMELITA	12687161644	NULL	12687161644	07269	DIPIRONA 500 MG/ML 2 ML SI IV IM AP	0.6900	0.6875	0.0025	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	0405a686318e3fc262f105ed4be24d95	CARMELITA	12687161644	NULL	12687161644	07269	DIPIRONA 500 MG/ML 2 ML SI IV IM AP	0.6900	0.6875	0.0025	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	0405a686318e3fc262f105ed4be24d95	CARMELITA	12687161644	NULL	12687161644	00426	AGUA BIDESTILADA 10 ML SI IV IM AP	0.8100	0.8077	0.0023	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	0405a686318e3fc262f105ed4be24d95	CARMELITA	12687161644	NULL	12687161644	07269	DIPIRONA 500 MG/ML 2 ML SI IV IM AP	0.6900	0.6873	0.0027	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	0405a686318e3fc262f105ed4be24d95	CARMELITA	12687161644	NULL	12687161644	07269	DIPIRONA 500 MG/ML 2 ML SI IV IM AP	0.6900	0.6873	0.0027	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	0405a686318e3fc262f105ed4be24d95	CARMELITA	12687161644	NULL	12687161644	19160	SERINGA DESC 20 ML UN	0.5400	0.5367	0.0033	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	0405a686318e3fc262f105ed4be24d95	CARMELITA	12687161644	NULL	12687161644	19160	SERINGA DESC 20 ML UN	0.5400	0.5367	0.0033	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	0405a686318e3fc262f105ed4be24d95	CARMELITA	12687161644	NULL	12687161644	19160	SERINGA DESC 20 ML UN	0.5400	0.5367	0.0033	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	0405a686318e3fc262f105ed4be24d95	CARMELITA	12687161644	NULL	12687161644	19160	SERINGA DESC 20 ML UN	0.5400	0.5367	0.0033	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	ea6abb4182a48f0934f3e9eb5affa056	DILVA	12697455440	NULL	12697455440	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1750	0.0050	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	500e4b8f04552b423f9db8f81073659f	FIDELIS	12763450340	NULL	12763450340	07269	DIPIRONA 500 MG/ML 2 ML SI IV IM AP	2.0600	2.0500	0.0000	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	500e4b8f04552b423f9db8f81073659f	FIDELIS	12763450340	NULL	12763450340	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1760	0.0040	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	27600	ONDANSETRONA 2 MG/ML 4 ML SI IM IV AP	13.5300	0.0000	13.5300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	27600	ONDANSETRONA 2 MG/ML 4 ML SI IM IV AP	13.5300	0.0000	13.5300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	00426	AGUA BIDESTILADA 10 ML SI IV IM AP	0.8100	0.8075	0.0025	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	33219	LUVA DE PROCEDIMENTO UNIDADE UN	0.6700	0.6680	0.0020	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	08664	ESPARADRAPO MICROPORE 50 X 10 CM CM	0.2600	0.2561	0.0039	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	25739	ELETRODO DESCARTAVEL (UTI) UN	4.6100	0.0000	4.6100	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	00817	ALGODAO HIDROFILO BOLINHA UN	0.5100	0.0000	0.5100	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	08648	ESPARADRAPO 10 X 4.5 CM CM	0.4000	0.0000	0.4000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	08648	ESPARADRAPO 10 X 4.5 CM CM	0.4000	0.0000	0.4000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	31d18d6607d9e742c53e748d6a55d740	CARLOS	12557779343	NULL	12557779343	11193	CLOREXIDINA 2 % ST TP ML	0.8000	0.2700	0.5300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	33219	LUVA DE PROCEDIMENTO UNIDADE UN	1.0000	0.6700	0.3300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	07269	DIPIRONA 500 MG/ML 2 ML SI IV IM AP	0.6900	0.0000	0.6900	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	33219	LUVA DE PROCEDIMENTO UNIDADE UN	1.0000	0.6700	0.3300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	33219	LUVA DE PROCEDIMENTO UNIDADE UN	1.0000	0.6700	0.3300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	9ffbbf7340bbd65e9e3baa9406d027f3	MARCO	12261811645	NULL	12261811645	33219	LUVA DE PROCEDIMENTO UNIDADE UN	1.0000	0.6700	0.3300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	9ffbbf7340bbd65e9e3baa9406d027f3	MARCO	12261811645	NULL	12261811645	33219	LUVA DE PROCEDIMENTO UNIDADE UN	1.0000	0.6700	0.3300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	9ffbbf7340bbd65e9e3baa9406d027f3	MARCO	12261811645	NULL	12261811645	02461	FENOTEROL 2 MG/ML 10 ML AE IN DS	0.4300	0.0000	0.4300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	9ffbbf7340bbd65e9e3baa9406d027f3	MARCO	12261811645	NULL	12261811645	30376	BROMETO DE IPRATROPIO 0,25MG/ML SL IN GT	2.0000	0.0000	2.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	9ffbbf7340bbd65e9e3baa9406d027f3	MARCO	12261811645	NULL	12261811645	02461	FENOTEROL 2 MG/ML 10 ML AE IN DS	0.2600	0.0000	0.2600	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	9ffbbf7340bbd65e9e3baa9406d027f3	MARCO	12261811645	NULL	12261811645	30376	BROMETO DE IPRATROPIO 0,25MG/ML SL IN GT	0.0200	0.0000	0.0200	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	9ffbbf7340bbd65e9e3baa9406d027f3	MARCO	12261811645	NULL	12261811645	30376	BROMETO DE IPRATROPIO 0,25MG/ML SL IN GT	1.8000	0.0000	1.8000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	9ffbbf7340bbd65e9e3baa9406d027f3	MARCO	12261811645	NULL	12261811645	02461	FENOTEROL 2 MG/ML 10 ML AE IN DS	1.2800	0.0000	1.2800	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	d4089ccef13567fd45b16fb0b60685fa	VERA	12656425943	NULL	12656425943	33219	LUVA DE PROCEDIMENTO UNIDADE UN	1.6700	0.6700	1.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	33219	LUVA DE PROCEDIMENTO UNIDADE UN	1.3300	0.6700	0.6600	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	00817	ALGODAO HIDROFILO BOLINHA UN	0.5100	0.2600	0.2500	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	cd2840524be5a3f1d0939f241e24f32b	MARIA	12705908340	NULL	12705908340	37761	ALCOOL ETILICO 70 % ST TP ML	0.0300	0.0200	0.0100	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	cd2840524be5a3f1d0939f241e24f32b	MARIA	12705908340	NULL	12705908340	37761	ALCOOL ETILICO 70 % ST TP ML	0.0300	0.0200	0.0100	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	cd2840524be5a3f1d0939f241e24f32b	MARIA	12705908340	NULL	12705908340	02461	FENOTEROL 2 MG/ML 10 ML AE IN DS	1.2800	0.0000	1.2800	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12603877940	NULL	12603877940	55018	ALGINATO DE CALCIO EM HIDROGEL GL TP GR	20.7000	13.8000	6.9000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12603877940	NULL	12603877940	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.6200	0.5100	0.1100	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12603877940	NULL	12603877940	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	10.2200	0.0000	10.2200	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12603877940	NULL	12603877940	07269	DIPIRONA 500 MG/ML 2 ML SI IV IM AP	2.7500	2.0600	0.6900	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12603877940	NULL	12603877940	33227	LUVA CIRURGICA PAR UN	11.5800	5.7900	5.7900	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12603877940	NULL	12603877940	00817	ALGODAO HIDROFILO BOLINHA UN	0.2600	0.1300	0.1300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12603877940	NULL	12603877940	37761	ALCOOL ETILICO 70 % ST TP ML	0.0300	0.0200	0.0100	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12603877940	NULL	12603877940	33227	LUVA CIRURGICA PAR UN	8.6900	7.2400	1.4500	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12603877940	NULL	12603877940	00817	ALGODAO HIDROFILO BOLINHA UN	0.2600	0.1300	0.1300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00728	ESPIRONOLACTONA 25 MG CP VO UN	0.4800	0.0000	0.4800	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	31445	OMEPRAZOL 20 MG CA VO UN	0.4500	0.0000	0.4500	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	19151	SERINGA DESC 10 ML UN	0.3300	0.0000	0.3300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	32204	CLORETO DE SODIO 0,9% 10 ML SI IV AP	2.4000	0.0000	2.4000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	30376	BROMETO DE IPRATROPIO 0,25MG/ML SL IN GT	3.2200	0.0000	3.2200	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	2b1cf1609fc72fb2a4e096bde8c345c1	JOAQUIM	12697596547	NULL	12697596547	25040014	ASSISTENCIA FISIATRICA RESPIRATORIA	0.0000	10.0600	NULL	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	3fb5c891f31bb9efcb05395066127c52	ALAIDE	12636273441	NULL	12636273441	00817	ALGODAO HIDROFILO BOLINHA UN	0.1300	0.1200	0.0000	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	a050ed50115d2a6dd0b15b99b39063da	ARI	12676101147	NULL	12676101147	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1750	0.0050	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	a050ed50115d2a6dd0b15b99b39063da	ARI	12676101147	NULL	12676101147	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1750	0.0050	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	a050ed50115d2a6dd0b15b99b39063da	ARI	12676101147	NULL	12676101147	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1750	0.0050	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	a050ed50115d2a6dd0b15b99b39063da	ARI	12676101147	NULL	12676101147	19160	SERINGA DESC 20 ML UN	0.5400	0.5367	0.0033	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	a050ed50115d2a6dd0b15b99b39063da	ARI	12676101147	NULL	12676101147	19160	SERINGA DESC 20 ML UN	0.5400	0.5367	0.0033	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	a050ed50115d2a6dd0b15b99b39063da	ARI	12676101147	NULL	12676101147	13404	OMEPRAZOL 40 MG + DIL. 10 ML PO IV FA	19.5800	19.5750	0.0050	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	a050ed50115d2a6dd0b15b99b39063da	ARI	12676101147	NULL	12676101147	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4067	0.0033	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	a050ed50115d2a6dd0b15b99b39063da	ARI	12676101147	NULL	12676101147	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4067	0.0033	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	a050ed50115d2a6dd0b15b99b39063da	ARI	12676101147	NULL	12676101147	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4067	0.0033	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	edffb7fef608512400078fdf75991573	CARLA	12728631049	NULL	12728631049	00426	AGUA BIDESTILADA 10 ML SI IV IM AP	0.8100	0.8067	0.0033	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	edffb7fef608512400078fdf75991573	CARLA	12728631049	NULL	12728631049	00426	AGUA BIDESTILADA 10 ML SI IV IM AP	0.8100	0.8067	0.0033	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	39df67956a358bf1eab89803158d25dd	HELENA	12655863342	NULL	12655863342	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1750	0.0050	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	39df67956a358bf1eab89803158d25dd	HELENA	12655863342	NULL	12655863342	33219	LUVA DE PROCEDIMENTO UNIDADE UN	0.6700	0.6659	0.0041	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	39df67956a358bf1eab89803158d25dd	HELENA	12655863342	NULL	12655863342	33219	LUVA DE PROCEDIMENTO UNIDADE UN	1.6700	1.6647	0.0053	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	9d06dbe3a8516628c3a045963dfb9c42	INAN	12623574546	NULL	12623574546	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1757	0.0043	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	9d06dbe3a8516628c3a045963dfb9c42	INAN	12623574546	NULL	12623574546	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1757	0.0043	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	d4089ccef13567fd45b16fb0b60685fa	VERA	12640482546	NULL	12640482546	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1754	0.0046	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	01081195	ad29f55cccce1ceaeb9c5f22ef02ddbc	CELIA	12793164715	NULL	12793164715	00010014	CONSULTA EM CONSULTORIO MEDICO	0.0000	35.0000	NULL	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	cd8240dfed3b190f93e1f35f15f53916	WANDELCY	12756680448	NULL	12756680448	25040014	ASSISTENCIA FISIATRICA RESPIRATORIA	0.0000	0.0000	NULL	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	de1a8276d878171456d7fc8f6dcd2457	ABEL	12667085545	NULL	12667085545	07269	DIPIRONA 500 MG/ML 2 ML SI IV IM AP	0.6900	0.6800	0.0000	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	de1a8276d878171456d7fc8f6dcd2457	ABEL	12764206443	NULL	12764206443	00426	AGUA BIDESTILADA 10 ML SI IV IM AP	0.8100	0.8067	0.0033	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	eecb3d883747b059c3fe231c34567476	AFFRIDES	12693180144	NULL	12693180144	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1770	0.0030	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	eecb3d883747b059c3fe231c34567476	AFFRIDES	12693180144	NULL	12693180144	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1770	0.0030	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	eecb3d883747b059c3fe231c34567476	AFFRIDES	12693180144	NULL	12693180144	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1770	0.0030	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	eecb3d883747b059c3fe231c34567476	AFFRIDES	12693180144	NULL	12693180144	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1770	0.0030	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	eecb3d883747b059c3fe231c34567476	AFFRIDES	12693180144	NULL	12693180144	00426	AGUA BIDESTILADA 10 ML SI IV IM AP	0.8100	0.8072	0.0028	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	eecb3d883747b059c3fe231c34567476	AFFRIDES	12693180144	NULL	12693180144	00426	AGUA BIDESTILADA 10 ML SI IV IM AP	0.8100	0.8072	0.0028	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	eecb3d883747b059c3fe231c34567476	AFFRIDES	12693180144	NULL	12693180144	00426	AGUA BIDESTILADA 10 ML SI IV IM AP	0.8100	0.8072	0.0028	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	eecb3d883747b059c3fe231c34567476	AFFRIDES	12693180144	NULL	12693180144	09733	ACETILCISTEINA 600MG PO VO SA	3.5000	3.4955	0.0045	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	eecb3d883747b059c3fe231c34567476	AFFRIDES	12693180144	NULL	12693180144	09733	ACETILCISTEINA 600MG PO VO SA	3.5000	3.4955	0.0045	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	eecb3d883747b059c3fe231c34567476	AFFRIDES	12693180144	NULL	12693180144	09733	ACETILCISTEINA 600MG PO VO SA	3.5000	3.4955	0.0045	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	eecb3d883747b059c3fe231c34567476	AFFRIDES	12693180144	NULL	12693180144	09733	ACETILCISTEINA 600MG PO VO SA	3.5000	3.4955	0.0045	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	eecb3d883747b059c3fe231c34567476	AFFRIDES	12693180144	NULL	12693180144	09733	ACETILCISTEINA 600MG PO VO SA	3.5000	3.4955	0.0045	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	08664	ESPARADRAPO MICROPORE 50 X 10 CM CM	0.2600	0.2561	0.0039	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	08664	ESPARADRAPO MICROPORE 50 X 10 CM CM	0.7700	0.7682	0.0018	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	08664	ESPARADRAPO MICROPORE 50 X 10 CM CM	0.7700	0.7682	0.0018	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	37761	ALCOOL ETILICO 70 % ST TP ML	0.0200	0.0150	0.0050	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	20672	SORO RINGER SIMPLES 500 ML SI IV BS	5.9400	5.9367	0.0033	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	20672	SORO RINGER SIMPLES 500 ML SI IV BS	5.9400	5.9367	0.0033	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	58661	ENCRISE (ARGIPRESSINA) 20 U/ML 1 ML SI SC	40.2400	40.2343	0.0057	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	22896	CEFUROXIMA 750 MG + DIL. 6 ML PO IM IV FA	26.1300	26.1271	0.0029	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	42358	FUROSEMIDA 10 MG/ML 2 ML SI IM IV AP	0.6000	0.5986	0.0014	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	42358	FUROSEMIDA 10 MG/ML 2 ML SI IM IV AP	0.6000	0.5986	0.0014	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4078	0.0022	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4078	0.0022	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4078	0.0022	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4078	0.0022	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4078	0.0022	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4078	0.0022	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4078	0.0022	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4078	0.0022	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	33227	LUVA CIRURGICA PAR UN	1.4500	1.4476	0.0024	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	33227	LUVA CIRURGICA PAR UN	1.4500	1.4476	0.0024	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	33227	LUVA CIRURGICA PAR UN	1.4500	1.4476	0.0024	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	33227	LUVA CIRURGICA PAR UN	1.4500	1.4476	0.0024	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	b288bbcfb9aecab51bcb0dba62ca0059	IVONETE	12743730847	NULL	12743730847	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4067	0.0033	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	b288bbcfb9aecab51bcb0dba62ca0059	IVONETE	12743730847	NULL	12743730847	19160	SERINGA DESC 20 ML UN	0.5400	0.5367	0.0033	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	b288bbcfb9aecab51bcb0dba62ca0059	IVONETE	12743730847	NULL	12743730847	19160	SERINGA DESC 20 ML UN	0.5400	0.5367	0.0033	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	b288bbcfb9aecab51bcb0dba62ca0059	IVONETE	12743730847	NULL	12743730847	19160	SERINGA DESC 20 ML UN	0.5400	0.5367	0.0033	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.3800	0.3800	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	53660	EQUIPO MACRO-GOTAS FLEXIVEL C/ INJETOR LATE	1.5900	0.0000	1.5900	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	33227	LUVA CIRURGICA PAR UN	1.4500	1.4500	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	33227	LUVA CIRURGICA PAR UN	1.4500	1.4500	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	08664	ESPARADRAPO MICROPORE 50 X 10 CM CM	0.7700	0.7700	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4080	0.0020	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4084	0.0016	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4084	0.0016	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4084	0.0016	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4084	0.0016	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.1036	-0.0036	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.1036	-0.0036	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	06343	CLINDAMICINA 600 MG 4 ML SI IM IV AP	13.0800	13.0800	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1965b0cdebe9017c3397c8641147759	JOSE	12705413746	NULL	12705413746	00035	ABOCATH (CATETER INTRAVENOSO) N. 14 A 22 UN	3.7700	3.7700	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	670141098c0309ac9be3db204bdc12cf	LEOSINA	12706525442	NULL	12706525442	33219	LUVA DE PROCEDIMENTO UNIDADE UN	1.0000	0.9900	0.0000	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	670141098c0309ac9be3db204bdc12cf	LEOSINA	12706525442	NULL	12706525442	05444	CLORETO DE POTASSIO 15% 10 ML SI IV AP	1.0300	1.0200	0.0000	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	20cbe2e07b1dcd2b6af609a50df7ae80	LUCELENA	12690767849	NULL	12690767849	19160	SERINGA DESC 20 ML UN	0.5400	0.5384	0.0016	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	00817	ALGODAO HIDROFILO BOLINHA UN	0.1300	0.1300	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	02461	FENOTEROL 2 MG/ML 10 ML AE IN DS	0.3400	0.0000	0.3400	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	32204	CLORETO DE SODIO 0,9% 10 ML SI IV AP	0.4800	0.4800	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	00426	AGUA BIDESTILADA 10 ML SI IV IM AP	0.8100	0.8067	0.0033	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	00426	AGUA BIDESTILADA 10 ML SI IV IM AP	0.8100	0.8067	0.0033	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	00426	AGUA BIDESTILADA 10 ML SI IV IM AP	0.8100	0.8067	0.0033	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	32204	CLORETO DE SODIO 0,9% 10 ML SI IV AP	0.4800	0.0000	0.4800	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	32204	CLORETO DE SODIO 0,9% 10 ML SI IV AP	0.9600	0.9600	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	05975	COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER	0.3000	0.0000	0.3000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00426	AGUA BIDESTILADA 10 ML SI IV IM AP	0.4000	0.0000	0.4000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00426	AGUA BIDESTILADA 10 ML SI IV IM AP	0.4000	0.0000	0.4000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00426	AGUA BIDESTILADA 10 ML SI IV IM AP	0.8100	0.0000	0.8100	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	08648	ESPARADRAPO 10 X 4.5 CM CM	0.4000	0.0000	0.4000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	32204	CLORETO DE SODIO 0,9% 10 ML SI IV AP	0.4800	0.0000	0.4800	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	32204	CLORETO DE SODIO 0,9% 10 ML SI IV AP	0.4800	0.0000	0.4800	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	32204	CLORETO DE SODIO 0,9% 10 ML SI IV AP	0.9600	0.9600	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	e715e2ae28a6229c8609756d3298bf52	MARIA	12734221144	NULL	12734221144	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1750	0.0050	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	e715e2ae28a6229c8609756d3298bf52	MARIA	12734221144	NULL	12734221144	30511	CEFALOTINA 1 G FA + DIL. 10 ML FA	4.6600	4.6550	0.0050	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	e715e2ae28a6229c8609756d3298bf52	MARIA	12734221144	NULL	12734221144	30511	CEFALOTINA 1 G FA + DIL. 10 ML FA	4.6600	4.6550	0.0050	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	29661	NOREPINEFRINA 2 MG/ML 4 ML SI IV AP	37.9900	37.9800	0.0000	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	05975	COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER	0.3000	0.3836	-0.0836	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	05975	COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER	0.3000	0.0000	0.3000	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	19119	SERINGA DESC 01 ML (INSULINA) UN	0.3100	0.3050	0.0050	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	19119	SERINGA DESC 01 ML (INSULINA) UN	0.3100	0.3050	0.0050	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	33537	PIPERACILINA 2 G + TAZOBACTAM 250 MG 30 ML	55.3400	55.3375	0.0025	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	33537	PIPERACILINA 2 G + TAZOBACTAM 250 MG 30 ML	55.3400	55.3375	0.0025	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	33537	PIPERACILINA 2 G + TAZOBACTAM 250 MG 30 ML	55.3400	55.3375	0.0025	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	33537	PIPERACILINA 2 G + TAZOBACTAM 250 MG 30 ML	55.3400	55.3375	0.0025	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	42358	FUROSEMIDA 10 MG/ML 2 ML SI IM IV AP	1.2000	1.1964	0.0036	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4061	0.0039	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4061	0.0039	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	33227	LUVA CIRURGICA PAR UN	1.4500	1.4477	0.0023	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	33227	LUVA CIRURGICA PAR UN	1.4500	1.4477	0.0023	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	08664	ESPARADRAPO MICROPORE 50 X 10 CM CM	0.7700	0.7650	0.0050	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	53660	EQUIPO MACRO-GOTAS FLEXIVEL C/ INJETOR LATE	1.5900	0.0000	1.5900	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	22748	LIDOCAINA 2% GE TP OU GR	2.5900	1.3000	1.2900	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	08664	ESPARADRAPO MICROPORE 50 X 10 CM CM	0.7700	0.7650	0.0050	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	19135	SERINGA DESC 03 ML UN	0.1500	0.0000	0.1500	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	19151	SERINGA DESC 10 ML UN	0.6700	0.6657	0.0043	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	19151	SERINGA DESC 10 ML UN	0.6700	0.6657	0.0043	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1772	0.0028	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1772	0.0028	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1772	0.0028	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	08664	ESPARADRAPO MICROPORE 50 X 10 CM CM	0.7700	0.7670	0.0030	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	08664	ESPARADRAPO MICROPORE 50 X 10 CM CM	0.7700	0.7670	0.0030	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	cd2840524be5a3f1d0939f241e24f32b	MARIA	12705908340	NULL	12705908340	32204	CLORETO DE SODIO 0,9% 10 ML SI IV AP	0.4800	0.0000	0.4800	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	cd2840524be5a3f1d0939f241e24f32b	MARIA	12705908340	NULL	12705908340	30376	BROMETO DE IPRATROPIO 0,25MG/ML SL IN GT	0.4000	0.0000	0.4000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	cd2840524be5a3f1d0939f241e24f32b	MARIA	12705908340	NULL	12705908340	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1764	0.0036	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	cd2840524be5a3f1d0939f241e24f32b	MARIA	12705908340	NULL	12705908340	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1764	0.0036	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	cd2840524be5a3f1d0939f241e24f32b	MARIA	12705908340	NULL	12705908340	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1764	0.0036	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	cd2840524be5a3f1d0939f241e24f32b	MARIA	12705908340	NULL	12705908340	02461	FENOTEROL 2 MG/ML 10 ML AE IN DS	0.4300	0.0000	0.4300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1766	0.0034	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1766	0.0034	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1766	0.0034	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1766	0.0034	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1766	0.0034	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1766	0.0034	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00426	AGUA BIDESTILADA 10 ML SI IV IM AP	0.8100	0.8077	0.0023	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	8a5ecfde671848d05ac757e0112e689c	TEREZINHA	12700337042	NULL	12700337042	10626	GLICOSE 50% 10 ML SI IV AP	2.7400	2.7350	0.0050	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	8a5ecfde671848d05ac757e0112e689c	TEREZINHA	12700337042	NULL	12700337042	10626	GLICOSE 50% 10 ML SI IV AP	2.7400	2.7350	0.0050	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	8a5ecfde671848d05ac757e0112e689c	TEREZINHA	12700337042	NULL	12700337042	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4064	0.0036	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	8a5ecfde671848d05ac757e0112e689c	TEREZINHA	12700337042	NULL	12700337042	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4071	0.0029	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	8a5ecfde671848d05ac757e0112e689c	TEREZINHA	12700337042	NULL	12700337042	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4071	0.0029	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	8a5ecfde671848d05ac757e0112e689c	TEREZINHA	12700337042	NULL	12700337042	19160	SERINGA DESC 20 ML UN	0.5400	0.5376	0.0024	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	8a5ecfde671848d05ac757e0112e689c	TEREZINHA	12700337042	NULL	12700337042	19160	SERINGA DESC 20 ML UN	0.5400	0.5376	0.0024	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	8a5ecfde671848d05ac757e0112e689c	TEREZINHA	12700337042	NULL	12700337042	19160	SERINGA DESC 20 ML UN	0.5400	0.5376	0.0024	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	70cf23c63f890f0b61da2542c3e13a09	TIAGO	12741864645	NULL	12741864645	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1762	0.0038	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	70cf23c63f890f0b61da2542c3e13a09	TIAGO	12741864645	NULL	12741864645	19160	SERINGA DESC 20 ML UN	0.5400	0.5367	0.0033	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	70cf23c63f890f0b61da2542c3e13a09	TIAGO	12741864645	NULL	12741864645	19160	SERINGA DESC 20 ML UN	0.5400	0.5367	0.0033	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	70cf23c63f890f0b61da2542c3e13a09	TIAGO	12741864645	NULL	12741864645	19160	SERINGA DESC 20 ML UN	0.5400	0.5367	0.0033	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	70cf23c63f890f0b61da2542c3e13a09	TIAGO	12741864645	NULL	12741864645	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4075	0.0025	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	70cf23c63f890f0b61da2542c3e13a09	TIAGO	12741864645	NULL	12741864645	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4075	0.0025	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	32204	CLORETO DE SODIO 0,9% 10 ML SI IV AP	0.4800	0.0000	0.4800	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	33227	LUVA CIRURGICA PAR UN	1.4500	1.4476	0.0024	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	33227	LUVA CIRURGICA PAR UN	1.4500	1.4476	0.0024	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	0111beed375944f60c7ad4a7fd4874f8	WALDIR	12746025744	NULL	12746025744	00426	AGUA BIDESTILADA 10 ML SI IV IM AP	1.6200	1.6147	0.0053	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	0111beed375944f60c7ad4a7fd4874f8	WALDIR	12746025744	NULL	12746025744	00426	AGUA BIDESTILADA 10 ML SI IV IM AP	1.6200	1.6147	0.0053	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	0111beed375944f60c7ad4a7fd4874f8	WALDIR	12746025744	NULL	12746025744	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4076	0.0024	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	0111beed375944f60c7ad4a7fd4874f8	WALDIR	12746025744	NULL	12746025744	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4076	0.0024	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	0111beed375944f60c7ad4a7fd4874f8	WALDIR	12746025744	NULL	12746025744	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4076	0.0024	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	0111beed375944f60c7ad4a7fd4874f8	WALDIR	12746025744	NULL	12746025744	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4076	0.0024	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	0111beed375944f60c7ad4a7fd4874f8	WALDIR	12746025744	NULL	12746025744	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4076	0.0024	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	0111beed375944f60c7ad4a7fd4874f8	WALDIR	12746025744	NULL	12746025744	19160	SERINGA DESC 20 ML UN	0.5400	0.5379	0.0021	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	0111beed375944f60c7ad4a7fd4874f8	WALDIR	12746025744	NULL	12746025744	19160	SERINGA DESC 20 ML UN	0.5400	0.5379	0.0021	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	0111beed375944f60c7ad4a7fd4874f8	WALDIR	12746025744	NULL	12746025744	19160	SERINGA DESC 20 ML UN	0.5400	0.5379	0.0021	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	00817	ALGODAO HIDROFILO BOLINHA UN	0.1300	0.0000	0.1300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	37761	ALCOOL ETILICO 70 % ST TP ML	0.0300	0.0000	0.0300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	00817	ALGODAO HIDROFILO BOLINHA UN	0.5100	0.0000	0.5100	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	37761	ALCOOL ETILICO 70 % ST TP ML	0.0300	0.0000	0.0300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	52353	ABAIXADOR DE LINGUA UN	0.0500	0.0267	0.0233	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	37761	ALCOOL ETILICO 70 % ST TP ML	0.0300	0.0000	0.0300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	37761	ALCOOL ETILICO 70 % ST TP ML	0.0600	0.0300	0.0300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	00817	ALGODAO HIDROFILO BOLINHA UN	0.5100	0.2600	0.2500	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	27596	TIRA TESTE PARA GLICOSE UN	1.0400	1.0400	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	27596	TIRA TESTE PARA GLICOSE UN	1.0400	1.0400	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	27596	TIRA TESTE PARA GLICOSE UN	1.0400	1.0400	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	05975	COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER	0.3000	0.0000	0.3000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12662414945	NULL	12662414945	19160	SERINGA DESC 20 ML UN	0.5400	0.5365	0.0035	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12662414945	NULL	12662414945	19160	SERINGA DESC 20 ML UN	0.5400	0.5367	0.0033	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12662414945	NULL	12662414945	19160	SERINGA DESC 20 ML UN	0.5400	0.5367	0.0033	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12662414945	NULL	12662414945	19160	SERINGA DESC 20 ML UN	0.5400	0.5367	0.0033	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12662414945	NULL	12662414945	13404	OMEPRAZOL 40 MG + DIL. 10 ML PO IV FA	19.5800	19.5750	0.0050	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12662414945	NULL	12662414945	19445	CLORETO DE POTASSIO 600 MG CA VO UN	0.4900	0.4867	0.0033	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12662414945	NULL	12662414945	19445	CLORETO DE POTASSIO 600 MG CA VO UN	0.4900	0.4867	0.0033	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12662414945	NULL	12662414945	19445	CLORETO DE POTASSIO 600 MG CA VO UN	0.4900	0.4867	0.0033	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12662414945	NULL	12662414945	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4071	0.0029	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12579183644	NULL	12579183644	05975	COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER	0.3000	0.3000	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12579183644	NULL	12579183644	05975	COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER	0.3000	0.3000	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12579183644	NULL	12579183644	33227	LUVA CIRURGICA PAR UN	1.4500	1.4476	0.0024	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1770	0.0030	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1770	0.0030	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1770	0.0030	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1770	0.0030	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1770	0.0030	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1770	0.0030	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	000441	TAXA DE DELEUCOTIZAÇÃO	NULL	0.0000	NULL	OPME INVALIDO	2201
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	11700	EQUIPO P/ BOMBA DE INFUSAO ENTERAL / PARENTERAL	NULL	0.0000	NULL	OPME INVALIDO	2201
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	00124	LUVA CIRURGICA UN	NULL	0.0000	NULL	OPME INVALIDO	2201
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	00172	SORO FISIOLOGICO 0,9% 500 ML SI IV BS	NULL	0.0000	NULL	OPME INVALIDO	2201
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	00172	SORO FISIOLOGICO 0,9% 500 ML SI IV BS	NULL	0.0000	NULL	OPME INVALIDO	2201
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	00172	SORO FISIOLOGICO 0,9% 500 ML SI IV BS	NULL	0.0000	NULL	OPME INVALIDO	2201
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	07269	DIPIRONA 500 MG/ML 2 ML SI IV IM AP	0.6900	0.0000	0.6900	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	32204	CLORETO DE SODIO 0,9% 10 ML SI IV AP	0.4800	0.0000	0.4800	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	32204	CLORETO DE SODIO 0,9% 10 ML SI IV AP	0.9600	0.4800	0.4800	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.2120	-0.1120	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.2120	-0.1120	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.2120	-0.1120	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.2120	-0.1120	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.2120	-0.1120	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.1060	-0.0060	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.1060	-0.0060	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.1060	-0.0060	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.1060	-0.0060	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.1060	-0.0060	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.1060	-0.0060	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.1060	-0.0060	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.1060	-0.0060	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.1060	-0.0060	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.1060	-0.0060	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	34827	TIORFAN (RACECADOTRILA) 100 MG CA VO UN	3.2000	6.4000	-3.2000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	19160	SERINGA DESC 20 ML UN	0.5400	0.5374	0.0026	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	07587	DRAMIN B6 DL (DIMENIDRINATO + PIRIDOXINA +	11.0637	13.2805	-11.0705	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	07587	DRAMIN B6 DL (DIMENIDRINATO + PIRIDOXINA +	11.0637	13.2805	-11.0705	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	31585	RANITIDINA 25 MG/ML 2 ML SI IV IM AP	0.9300	0.9334	-0.0034	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	19151	SERINGA DESC 10 ML UN	0.6634	1.0003	-0.6703	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	19151	SERINGA DESC 10 ML UN	0.6634	1.0003	-0.6703	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	19151	SERINGA DESC 10 ML UN	0.3300	0.6669	-0.3369	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	19151	SERINGA DESC 10 ML UN	0.3300	0.6669	-0.3369	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	19151	SERINGA DESC 10 ML UN	0.3300	0.6669	-0.3369	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	13935	METAMUCIL (PLANTAGO OVATA) 5,85 G PO VO E	4.9236	7.3907	-4.9307	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	11193	CLOREXIDINA 2 % ST TP ML	0.5300	0.5320	-0.0020	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	800720d33fe0defb6121e82dd216d044	JALMO	12786952647	NULL	12786952647	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	01611	CLORETO DE POTASSIO 600 MG CA VO UN	0.0000	0.0000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00182	SULFATO DE MAGNESIO 500 MG/ML 10 ML SI IM IV AP	0.0000	5.4300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	20010010	Eletrocardiograma - Ecg	0.0000	16.5300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	02246	HIDROCORTISONA 100 MG PO IM IV FA	0.0000	0.0000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	02246	HIDROCORTISONA 100 MG PO IM IV FA	0.0000	2.8300	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	02246	HIDROCORTISONA 100 MG PO IM IV FA	0.0000	2.8300	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	02246	HIDROCORTISONA 100 MG PO IM IV FA	0.0000	5.6700	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	02246	HIDROCORTISONA 100 MG PO IM IV FA	0.0000	5.6700	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	02246	HIDROCORTISONA 100 MG PO IM IV FA	0.0000	5.6689	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	02249	PREDNISONA 20 MG CP VO UN	0.0000	0.0000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	25040014	Fisioterapia Respiratória - em Doente Clínico Internado	0.0000	45.2500	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	26981	SORO FISIOLOGICO 0,9% 10 ML SI IV AP	0.0000	0.0000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	26981	SORO FISIOLOGICO 0,9% 10 ML SI IV AP	0.0000	0.9600	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	26981	SORO FISIOLOGICO 0,9% 10 ML SI IV AP	0.0000	0.9600	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00613	CLINDAMICINA 600 MG 4 ML SI IM IV AP	0.0000	13.0800	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00613	CLINDAMICINA 600 MG 4 ML SI IM IV AP	0.0000	13.0800	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	07802	PIPERACILINA 4 G + TAZOBACTAM 500 MG PO IV FA	0.0000	83.4500	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	07802	PIPERACILINA 4 G + TAZOBACTAM 500 MG PO IV FA	0.0000	83.4500	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	07802	PIPERACILINA 4 G + TAZOBACTAM 500 MG PO IV FA	0.0000	83.4500	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00796	FLORATIL (SACCHAROMYCES BOULARDII) 200 MG PO VO	0.0000	4.4400	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	08829	Bricanyl 0,5mg Inj. Ampola C/ 1ml	0.0000	3.5900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	08829	Bricanyl 0,5mg Inj. Ampola C/ 1ml	0.0000	3.5900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	09071	ACETILCISTEINA 600MG PO VO SA	0.0000	3.4950	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	09071	ACETILCISTEINA 600MG PO VO SA	0.0000	3.4950	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	09071	ACETILCISTEINA 600MG PO VO SA	0.0000	3.4950	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	09071	ACETILCISTEINA 600MG PO VO SA	0.0000	3.4950	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00124	LUVA CIRURGICA UN	0.0000	1.4475	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00124	LUVA CIRURGICA UN	0.0000	1.4475	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4062	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4062	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4062	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4062	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4062	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4062	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4062	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4062	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4062	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4062	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4062	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4062	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4062	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4062	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4062	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	6.8124	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	01584	NEOSTIGMINA 0,5 MG/ML 1 ML SI IM IV SC AP	0.0000	0.7667	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	01584	NEOSTIGMINA 0,5 MG/ML 1 ML SI IM IV SC AP	0.0000	0.7667	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	01584	NEOSTIGMINA 0,5 MG/ML 1 ML SI IM IV SC AP	0.0000	0.7667	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	24082	BROMOPRIDA 5 MG/ML 2 ML SI IM IV AP	0.0000	2.7300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	24082	BROMOPRIDA 5 MG/ML 2 ML SI IM IV AP	0.0000	2.7300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	24082	BROMOPRIDA 5 MG/ML 2 ML SI IM IV AP	0.0000	2.7300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	24082	BROMOPRIDA 5 MG/ML 2 ML SI IM IV AP	0.0000	2.7300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00090	SERINGA DESC 20 ML UN	0.0000	0.5371	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00090	SERINGA DESC 20 ML UN	0.0000	0.5371	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00090	SERINGA DESC 20 ML UN	0.0000	0.5371	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00090	SERINGA DESC 20 ML UN	0.0000	0.5371	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00090	SERINGA DESC 20 ML UN	0.0000	0.5371	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00090	SERINGA DESC 20 ML UN	0.0000	0.5371	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00090	SERINGA DESC 20 ML UN	0.0000	0.5371	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00090	SERINGA DESC 20 ML UN	0.0000	0.5371	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00090	SERINGA DESC 20 ML UN	0.0000	0.5371	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00090	SERINGA DESC 20 ML UN	0.0000	0.5371	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00090	SERINGA DESC 20 ML UN	0.0000	0.5371	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00090	SERINGA DESC 20 ML UN	0.0000	0.5371	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00090	SERINGA DESC 20 ML UN	0.0000	0.5371	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00090	SERINGA DESC 20 ML UN	0.0000	0.5400	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00090	SERINGA DESC 20 ML UN	0.0000	0.5371	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00090	SERINGA DESC 20 ML UN	0.0000	0.5371	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4088	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4088	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4088	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4088	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4088	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1766	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1766	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1766	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00090	SERINGA DESC 20 ML UN	0.0000	0.5400	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00090	SERINGA DESC 20 ML UN	0.0000	0.5387	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00090	SERINGA DESC 20 ML UN	0.0000	0.5400	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00090	SERINGA DESC 20 ML UN	0.0000	0.5387	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00090	SERINGA DESC 20 ML UN	0.0000	0.5387	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00090	SERINGA DESC 20 ML UN	0.0000	0.5387	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00090	SERINGA DESC 20 ML UN	0.0000	0.5387	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00090	SERINGA DESC 20 ML UN	0.0000	0.5387	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00090	SERINGA DESC 20 ML UN	0.0000	0.5387	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00090	SERINGA DESC 20 ML UN	0.0000	0.5387	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00090	SERINGA DESC 20 ML UN	0.0000	0.5387	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00090	SERINGA DESC 20 ML UN	0.0000	0.5387	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00090	SERINGA DESC 20 ML UN	0.0000	0.5387	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	4c68006246c347121db1f06edf5e5051	MARIA	12734155245	NULL	12734155245	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.0000	0.6900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12550571048	NULL	12550571048	00124	LUVA CIRURGICA UN	0.0000	1.4470	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12550571048	NULL	12550571048	00124	LUVA CIRURGICA UN	0.0000	1.4473	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12550571048	NULL	12550571048	00125	LUVA CIRURGICA UN	0.0000	1.4473	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12550571048	NULL	12550571048	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12550571048	NULL	12550571048	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4068	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12550571048	NULL	12550571048	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4074	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12550571048	NULL	12550571048	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4074	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12550571048	NULL	12550571048	01611	CLORETO DE POTASSIO 600 MG CA VO UN	0.0000	0.4867	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12550571048	NULL	12550571048	01611	CLORETO DE POTASSIO 600 MG CA VO UN	0.0000	0.4867	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12550571048	NULL	12550571048	25040014	Fisioterapia Respiratória - em Doente Clínico Internado	0.0000	10.0600	NULL	EXAME NAO AUTORIZADO	2707
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12550571048	NULL	12550571048	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.3075	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12550571048	NULL	12550571048	00037	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1775	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12550571048	NULL	12550571048	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.0000	0.8089	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12550571048	NULL	12550571048	51208	SORO RINGER SIMPLES 500 ML SI IV BS	0.0000	11.8700	NULL	EXAME NAO AUTORIZADO	2707
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12550571048	NULL	12550571048	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1775	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12550571048	NULL	12550571048	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1775	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12550571048	NULL	12550571048	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1775	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12550571048	NULL	12550571048	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1775	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12550571048	NULL	12550571048	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1775	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12550571048	NULL	12550571048	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1775	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12550571048	NULL	12550571048	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1775	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12550571048	NULL	12550571048	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1775	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	9ffbbf7340bbd65e9e3baa9406d027f3	MARCO	12261811645	NULL	12261811645	00090	SERINGA DESC 20 ML UN	0.0000	0.5376	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12579183644	NULL	12579183644	00124	LUVA CIRURGICA UN	0.0000	1.4476	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12579183644	NULL	12579183644	00124	LUVA CIRURGICA UN	0.0000	1.4476	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12579183644	NULL	12579183644	00124	LUVA CIRURGICA UN	0.0000	1.4476	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12579183644	NULL	12579183644	25040014	Fisioterapia Respiratória - em Doente Clínico Internado	0.0000	10.0600	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12579183644	NULL	12579183644	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12579183644	NULL	12579183644	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12579183644	NULL	12579183644	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12579183644	NULL	12579183644	00091	SERINGA DESC 01 ML (INSULINA) UN	0.0000	0.3050	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12579183644	NULL	12579183644	00091	SERINGA DESC 01 ML (INSULINA) UN	0.0000	0.3050	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12579183644	NULL	12579183644	00091	SERINGA DESC 01 ML (INSULINA) UN	0.0000	0.3050	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	00124	LUVA CIRURGICA UN	0.0000	1.4482	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	00124	LUVA CIRURGICA UN	0.0000	1.4482	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	00124	LUVA CIRURGICA UN	0.0000	1.4482	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	00124	LUVA CIRURGICA UN	0.0000	1.4500	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	00124	LUVA CIRURGICA UN	0.0000	1.4482	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	00128	LUVA DE PROCEDIMENTO UNIDADE UN	0.0000	1.6700	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4094	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4094	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4094	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.0000	0.4000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.0000	0.4000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.0000	0.4000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.0000	0.4000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.0000	0.4000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.0000	0.4000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1752	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1752	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1800	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1800	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	51241	AGULHA 123X45	0.0000	0.1900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	51649	ALCOOL ETILICO 70 % ST TP ML	0.0000	0.0000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	52392	SONDA DE ASPIRAÇAO TRAQUEAL C/ VALVULA UN	0.0000	0.9352	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	52392	SONDA DE ASPIRAÇAO TRAQUEAL C/ VALVULA UN	0.0000	0.9400	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	52392	SONDA DE ASPIRAÇAO TRAQUEAL C/ VALVULA UN	0.0000	0.9400	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	52392	SONDA DE ASPIRAÇAO TRAQUEAL C/ VALVULA UN	0.0000	0.9352	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.0000	0.6876	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.0000	0.6874	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.0000	0.6874	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.3500	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	53945	ACIDO ASCORBICO 500 MG CP VO UN	0.0000	0.5900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00128	LUVA DE PROCEDIMENTO UNIDADE UN	0.0000	1.6700	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00128	LUVA DE PROCEDIMENTO UNIDADE UN	0.0000	1.6700	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	01496	FENITOINA 50 MG/ML 5 ML SI IM IV AP	0.0000	2.3400	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	01496	FENITOINA 50 MG/ML 5 ML SI IM IV AP	0.0000	2.3400	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	01584	NEOSTIGMINA 0,5 MG/ML 1 ML SI IM IV SC AP	0.0000	0.7662	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00169	SORO GLICOSADO 5% 500 ML SI IV BS	0.0000	3.6715	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00171	SORO FISIOLOGICO 0,9% 250 ML SI IV BS	0.0000	3.9400	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	24082	BROMOPRIDA 5 MG/ML 2 ML SI IM IV AP	0.0000	2.7300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	24082	BROMOPRIDA 5 MG/ML 2 ML SI IM IV AP	0.0000	2.7300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	26981	SORO FISIOLOGICO 0,9% 10 ML SI IV AP	0.0000	0.9600	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	26981	SORO FISIOLOGICO 0,9% 10 ML SI IV AP	0.0000	0.9600	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	ea4ad2636c25d8e3dbb569ae62db71e7	IONE	12489788840	NULL	12489788840	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1800	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	ea4ad2636c25d8e3dbb569ae62db71e7	IONE	12489788840	NULL	12489788840	00737	CEFTRIAXONA IV 1G + DIL. 10 ML PO IV FA	0.0000	27.0600	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	d17b3c5ae418d82694895a326dee545a	ODILIA	12670516743	NULL	12670516743	102001	DIARIA DE APARTAMENTO	0.0000	288.8881	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	d17b3c5ae418d82694895a326dee545a	ODILIA	12670516743	NULL	12670516743	102001	DIARIA DE APARTAMENTO	0.0000	288.8882	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	d17b3c5ae418d82694895a326dee545a	ODILIA	12670516743	NULL	12670516743	102001	DIARIA DE APARTAMENTO	0.0000	288.8882	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	d17b3c5ae418d82694895a326dee545a	ODILIA	12670516743	NULL	12670516743	102001	DIARIA DE APARTAMENTO	0.0000	288.8882	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	d17b3c5ae418d82694895a326dee545a	ODILIA	12670516743	NULL	12670516743	00128	LUVA DE PROCEDIMENTO UNIDADE UN	0.0000	1.0000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	d17b3c5ae418d82694895a326dee545a	ODILIA	12670516743	NULL	12670516743	02197	METAMUCIL (PLANTAGO OVATA) 3,4 G PO VO EV	0.0000	2.4600	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	d17b3c5ae418d82694895a326dee545a	ODILIA	12670516743	NULL	12670516743	02197	METAMUCIL (PLANTAGO OVATA) 3,4 G PO VO EV	0.0000	2.4600	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	d17b3c5ae418d82694895a326dee545a	ODILIA	12670516743	NULL	12670516743	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	d17b3c5ae418d82694895a326dee545a	ODILIA	12670516743	NULL	12670516743	44001	BOLSA COLETORA (SISTEMA ABERTO) UN	0.0000	0.3200	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	d17b3c5ae418d82694895a326dee545a	ODILIA	12670516743	NULL	12670516743	51208	SORO RINGER SIMPLES 500 ML SI IV BS	0.0000	5.9400	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	d17b3c5ae418d82694895a326dee545a	ODILIA	12670516743	NULL	12670516743	51208	SORO RINGER SIMPLES 500 ML SI IV BS	0.0000	5.9400	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1965b0cdebe9017c3397c8641147759	JOSE	12705413746	NULL	12705413746	102001	DIARIA DE APARTAMENTO	0.0000	288.8881	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1965b0cdebe9017c3397c8641147759	JOSE	12705413746	NULL	12705413746	102001	DIARIA DE APARTAMENTO	0.0000	288.8882	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1965b0cdebe9017c3397c8641147759	JOSE	12705413746	NULL	12705413746	102001	DIARIA DE APARTAMENTO	0.0000	288.8881	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1965b0cdebe9017c3397c8641147759	JOSE	12705413746	NULL	12705413746	11232	CLEXANE (ENOXAPARINA) 40 MG SI IV SC SE	0.0000	20.2466	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1965b0cdebe9017c3397c8641147759	JOSE	12705413746	NULL	12705413746	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4092	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1965b0cdebe9017c3397c8641147759	JOSE	12705413746	NULL	12705413746	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4074	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1965b0cdebe9017c3397c8641147759	JOSE	12705413746	NULL	12705413746	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4074	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1965b0cdebe9017c3397c8641147759	JOSE	12705413746	NULL	12705413746	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4074	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1965b0cdebe9017c3397c8641147759	JOSE	12705413746	NULL	12705413746	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4074	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4072	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4072	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	01611	CLORETO DE POTASSIO 600 MG CA VO UN	0.0000	0.4867	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	01611	CLORETO DE POTASSIO 600 MG CA VO UN	0.0000	0.4867	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	01611	CLORETO DE POTASSIO 600 MG CA VO UN	0.0000	0.4867	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	02246	HIDROCORTISONA 100 MG PO IM IV FA	0.0000	2.8300	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	02246	HIDROCORTISONA 100 MG PO IM IV FA	0.0000	2.8300	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	02246	HIDROCORTISONA 100 MG PO IM IV FA	0.0000	2.8300	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	02246	HIDROCORTISONA 100 MG PO IM IV FA	0.0000	2.8300	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	00404	LACTULOSE 667 MG/ML XP VO ML	0.0000	0.2100	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	00404	LACTULOSE 667 MG/ML XP VO ML	0.0000	6.4300	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	00404	LACTULOSE 667 MG/ML XP VO ML	0.0000	6.4300	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.0000	0.8067	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.0000	0.8067	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.0000	0.8067	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1771	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1771	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1771	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1771	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1771	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1771	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1771	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1771	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1771	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	00172	SORO FISIOLOGICO 0,9% 500 ML SI IV BS	0.0000	3.1426	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	24571	CLINDAMICINA 600 MG 4 ML SI IM IV AP	0.0000	13.0800	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	24571	CLINDAMICINA 600 MG 4 ML SI IM IV AP	0.0000	13.0800	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	24571	CLINDAMICINA 600 MG 4 ML SI IM IV AP	0.0000	13.0800	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	24571	CLINDAMICINA 600 MG 4 ML SI IM IV AP	0.0000	13.0800	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	24571	CLINDAMICINA 600 MG 4 ML SI IM IV AP	0.0000	13.0800	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	24571	CLINDAMICINA 600 MG 4 ML SI IM IV AP	0.0000	13.0800	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	24571	CLINDAMICINA 600 MG 4 ML SI IM IV AP	0.0000	13.0800	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	dd486d36a88cfef0b44fe652638a0164	DELFINA	12660326244	NULL	12660326244	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	dd486d36a88cfef0b44fe652638a0164	DELFINA	12660326244	NULL	12660326244	14191	OMEPRAZOL 20 MG CA VO UN	0.0000	0.9000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	dd486d36a88cfef0b44fe652638a0164	DELFINA	12660326244	NULL	12660326244	00406	FUROSEMIDA 10 MG/ML 2 ML SI IM IV AP	0.0000	0.6000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	dd486d36a88cfef0b44fe652638a0164	DELFINA	12660326244	NULL	12660326244	00406	FUROSEMIDA 10 MG/ML 2 ML SI IM IV AP	0.0000	1.2000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	dd486d36a88cfef0b44fe652638a0164	DELFINA	12660326244	NULL	12660326244	00406	FUROSEMIDA 10 MG/ML 2 ML SI IM IV AP	0.0000	1.2000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	dd486d36a88cfef0b44fe652638a0164	DELFINA	12660326244	NULL	12660326244	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.0000	0.8100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	dd486d36a88cfef0b44fe652638a0164	DELFINA	12660326244	NULL	12660326244	51584	ESPARADRAPO MICROPORE	0.0000	0.7700	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	dd486d36a88cfef0b44fe652638a0164	DELFINA	12660326244	NULL	12660326244	06400	CARVEDILOL 3,125 MG CP VO UN	0.0000	0.7300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	dd486d36a88cfef0b44fe652638a0164	DELFINA	12660326244	NULL	12660326244	06400	CARVEDILOL 3,125 MG CP VO UN	0.0000	0.7300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	dd486d36a88cfef0b44fe652638a0164	DELFINA	12660326244	NULL	12660326244	06400	CARVEDILOL 3,125 MG CP VO UN	0.0000	0.7300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	102001	DIARIA DE APARTAMENTO	0.0000	288.8900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	102001	DIARIA DE APARTAMENTO	0.0000	288.8900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	102001	DIARIA DE APARTAMENTO	0.0000	288.8900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	102001	DIARIA DE APARTAMENTO	0.0000	288.8900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	00128	LUVA DE PROCEDIMENTO UNIDADE UN	0.0000	1.0000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	51589	ESPARADRAPO 10 X 4.5 CM CM	0.0000	0.4000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	51649	ALCOOL ETILICO 70 % ST TP ML	0.0000	0.0300	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	00090	SERINGA DESC 20 ML UN	0.0000	0.5400	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	00090	SERINGA DESC 20 ML UN	0.0000	0.5400	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	00090	SERINGA DESC 20 ML UN	0.0000	0.5400	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	00090	SERINGA DESC 20 ML UN	0.0000	0.5400	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	00919	ALGODAO HIDROFILO BOLINHA UN	0.0000	0.2600	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	00919	ALGODAO HIDROFILO BOLINHA UN	0.0000	0.2600	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	00919	ALGODAO HIDROFILO BOLINHA UN	0.0000	0.2600	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	00943	EQUIPO POLIFIX 2 VIAS UN	0.0000	7.6500	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	f3ad474c8c562757c4d1a959ff0961c4	DJALMA	12718763240	NULL	12718763240	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	f3ad474c8c562757c4d1a959ff0961c4	DJALMA	12718763240	NULL	12718763240	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	f3ad474c8c562757c4d1a959ff0961c4	DJALMA	12718763240	NULL	12718763240	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	f3ad474c8c562757c4d1a959ff0961c4	DJALMA	12718763240	NULL	12718763240	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	f3ad474c8c562757c4d1a959ff0961c4	DJALMA	12718763240	NULL	12718763240	00037	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	f3ad474c8c562757c4d1a959ff0961c4	DJALMA	12718763240	NULL	12718763240	00037	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	f3ad474c8c562757c4d1a959ff0961c4	DJALMA	12718763240	NULL	12718763240	00037	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	f3ad474c8c562757c4d1a959ff0961c4	DJALMA	12718763240	NULL	12718763240	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1800	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	f3ad474c8c562757c4d1a959ff0961c4	DJALMA	12718763240	NULL	12718763240	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1800	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	f3ad474c8c562757c4d1a959ff0961c4	DJALMA	12718763240	NULL	12718763240	51584	ESPARADRAPO MICROPORE	0.0000	0.7700	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	f3ad474c8c562757c4d1a959ff0961c4	DJALMA	12718763240	NULL	12718763240	00090	SERINGA DESC 20 ML UN	0.0000	0.5400	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	f3ad474c8c562757c4d1a959ff0961c4	DJALMA	12718763240	NULL	12718763240	00090	SERINGA DESC 20 ML UN	0.0000	0.5400	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	f3ad474c8c562757c4d1a959ff0961c4	DJALMA	12718763240	NULL	12718763240	00090	SERINGA DESC 20 ML UN	0.0000	0.5400	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	806bfa8e76209648a4ae145ff436d092	GILBERTO	12692620640	NULL	12692620640	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.0000	0.6875	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3fb5c891f31bb9efcb05395066127c52	ALAIDE	12636273441	NULL	12636273441	14250	PARACETAMOL 750 MG CP VO UN	0.0000	0.4500	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00090	SERINGA DESC 20 ML UN	0.5400	0.2200	0.3200	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00090	SERINGA DESC 20 ML UN	0.5400	0.2200	0.3200	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00090	SERINGA DESC 20 ML UN	0.5400	0.2200	0.3200	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00090	SERINGA DESC 20 ML UN	0.5400	0.2200	0.3200	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.6900	0.2700	0.4200	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.6900	0.2700	0.4200	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.6900	0.2700	0.4200	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.6900	0.2700	0.4200	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.6900	0.2700	0.4200	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.6900	0.2700	0.4200	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.6900	0.2700	0.4200	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.6900	0.2700	0.4200	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.6900	0.2700	0.4200	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.6900	0.2700	0.4200	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.6900	0.2700	0.4200	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.6900	0.2700	0.4200	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00471	LIDOCAINA 2% GE OU TP GR	2.5900	1.0100	1.5800	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00493	BROMOPRIDA 5 MG/ML 2 ML SI IM IV AP	2.7300	1.0600	1.6700	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00172	SORO FISIOLOGICO 0,9% 500 ML SI IV BS	4.7300	1.8400	2.8900	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	25040014	Fisioterapia Respiratória - em Doente Clínico Internado	5.0300	1.9600	3.0700	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	53144	TRAMAL	5.9900	2.3300	3.6600	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	53144	TRAMAL	5.9900	2.3300	3.6600	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00613	CLINDAMICINA 600 MG 4 ML SI IM IV AP	13.0800	5.1000	7.9800	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00613	CLINDAMICINA 600 MG 4 ML SI IM IV AP	13.0800	5.1000	7.9800	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	16b1e9f62f247f02ad5cac910ee15b4e	BERCHOLINA	12631612848	NULL	12631612848	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4081	0.0019	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	16b1e9f62f247f02ad5cac910ee15b4e	BERCHOLINA	12631612848	NULL	12631612848	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4081	0.0019	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	16b1e9f62f247f02ad5cac910ee15b4e	BERCHOLINA	12631612848	NULL	12631612848	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4081	0.0019	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	16b1e9f62f247f02ad5cac910ee15b4e	BERCHOLINA	12631612848	NULL	12631612848	33537	PIPERACILINA 2 G + TAZOBACTAM 250 MG 30 ML	55.3400	55.3386	0.0014	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	16b1e9f62f247f02ad5cac910ee15b4e	BERCHOLINA	12631612848	NULL	12631612848	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4081	0.0019	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	16b1e9f62f247f02ad5cac910ee15b4e	BERCHOLINA	12631612848	NULL	12631612848	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4081	0.0019	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	16b1e9f62f247f02ad5cac910ee15b4e	BERCHOLINA	12631612848	NULL	12631612848	36432	HIDROCLOROTIAZIDA 25 MG CP VO UN	0.2400	0.2300	0.0100	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	16b1e9f62f247f02ad5cac910ee15b4e	BERCHOLINA	12631612848	NULL	12631612848	00090	SERINGA DESC 20 ML UN	0.5400	0.5200	0.0200	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	16b1e9f62f247f02ad5cac910ee15b4e	BERCHOLINA	12631612848	NULL	12631612848	00090	SERINGA DESC 20 ML UN	0.5400	0.5200	0.0200	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	16b1e9f62f247f02ad5cac910ee15b4e	BERCHOLINA	12631612848	NULL	12631612848	00090	SERINGA DESC 20 ML UN	0.5400	0.5200	0.0200	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	16b1e9f62f247f02ad5cac910ee15b4e	BERCHOLINA	12631612848	NULL	12631612848	00171	SORO FISIOLOGICO 0,9% 250 ML SI IV BS	3.9400	3.7600	0.1800	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	01081195	8cbe40d11795e1798bfc2eb87b3ce167	TANIA	12791026611	NULL	12791026611	00010014	CONSULTA EM CONSULTORIO MEDICO	0.0000	0.0000	50.0000	GUIA DE CONSULTA NAO EXECUTADA	0622
Glosa Min	2018-10-03 00:00:00.000000	1084117	b288bbcfb9aecab51bcb0dba62ca0059	IVONETE	12743730847	NULL	12743730847	55921	CISATRACURIO 20 MG 10 ML SI IV FR	117.6800	58.8400	58.8400	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12550571048	NULL	12550571048	37761	ALCOOL ETILICO 70 % ST TP ML	0.0300	0.0200	0.0100	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12550571048	NULL	12550571048	08648	ESPARADRAPO 10 X 4.5 CM CM	0.4000	0.2000	0.2000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12550571048	NULL	12550571048	33219	LUVA DE PROCEDIMENTO UNIDADE UN	1.0000	0.6700	0.3300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12550571048	NULL	12550571048	00817	ALGODAO HIDROFILO BOLINHA UN	0.2600	0.1300	0.1300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12550571048	NULL	12550571048	05975	COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER	0.3000	0.1500	0.1500	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12550571048	NULL	12550571048	08648	ESPARADRAPO 10 X 4.5 CM CM	0.4000	0.2000	0.2000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12550571048	NULL	12550571048	32891	EQUIPO POLIFIX 2ş VIAS UN	2.5500	0.0000	2.5500	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12550571048	NULL	12550571048	37761	ALCOOL ETILICO 70 % ST TP ML	0.0600	0.0200	0.0400	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	57495	FILTRO BARREIRA E REGENERADOR DE CALOR E UM	24.0000	0.0000	24.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	75bcd473a0dc7c7a6751499b38a4a034	JOAQUIM	12692852143	NULL	12692852143	08648	ESPARADRAPO 10 X 4.5 CM CM	0.4000	0.1000	0.3000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	75bcd473a0dc7c7a6751499b38a4a034	JOAQUIM	12692852143	NULL	12692852143	08648	ESPARADRAPO 10 X 4.5 CM CM	0.4000	0.1000	0.3000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	75bcd473a0dc7c7a6751499b38a4a034	JOAQUIM	12692852143	NULL	12692852143	37761	ALCOOL ETILICO 70 % ST TP ML	0.0300	0.0200	0.0100	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	75bcd473a0dc7c7a6751499b38a4a034	JOAQUIM	12692852143	NULL	12692852143	00817	ALGODAO HIDROFILO BOLINHA UN	0.2600	0.1300	0.1300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	75bcd473a0dc7c7a6751499b38a4a034	JOAQUIM	12692852143	NULL	12692852143	00817	ALGODAO HIDROFILO BOLINHA UN	0.2600	0.1300	0.1300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	4668d2494ed6c4b2d18be299efcb26a2	JOAO	12469689344	NULL	12469689344	37761	ALCOOL ETILICO 70 % ST TP ML	0.3000	0.2100	0.0900	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	4668d2494ed6c4b2d18be299efcb26a2	JOAO	12469689344	NULL	12469689344	11193	CLOREXIDINA 2 % ST TP ML	0.5300	0.2700	0.2600	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	4668d2494ed6c4b2d18be299efcb26a2	JOAO	12469689344	NULL	12469689344	08664	ESPARADRAPO MICROPORE 50 X 10 CM CM	0.7700	0.2600	0.5100	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	4668d2494ed6c4b2d18be299efcb26a2	JOAO	12469689344	NULL	12469689344	08648	ESPARADRAPO 10 X 4.5 CM CM	0.4000	0.2600	0.1400	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	32204	CLORETO DE SODIO 0,9% 10 ML SI IV AP	0.9600	0.0000	0.9600	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	19151	SERINGA DESC 10 ML UN	0.3300	0.0000	0.3300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	11134	HEPARINA 5000 UI/ML 5 ML SI IV SC ML	2.8800	0.0000	2.8800	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	32891	EQUIPO POLIFIX 2ş VIAS UN	2.5500	0.0000	2.5500	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1900	0.0000	0.1900	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.0000	0.1000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12603877940	NULL	12603877940	08664	ESPARADRAPO MICROPORE 50 X 10 CM CM	0.7700	0.0000	0.7700	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	08664	ESPARADRAPO MICROPORE 50 X 10 CM CM	1.2800	0.5100	0.7700	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	33219	LUVA DE PROCEDIMENTO UNIDADE UN	1.0000	0.6700	0.3300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	33219	LUVA DE PROCEDIMENTO UNIDADE UN	1.0000	0.6700	0.3300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	33219	LUVA DE PROCEDIMENTO UNIDADE UN	1.0000	0.6700	0.3300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00817	ALGODAO HIDROFILO BOLINHA UN	0.2600	0.1300	0.1300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00035	ABOCATH (CATETER INTRAVENOSO) N. 14 A 22 UN	3.7700	0.0000	3.7700	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	08648	ESPARADRAPO 10 X 4.5 CM CM	0.4000	0.0000	0.4000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	33219	LUVA DE PROCEDIMENTO UNIDADE UN	1.0000	0.6700	0.3300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00817	ALGODAO HIDROFILO BOLINHA UN	0.2600	0.1300	0.1300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	22748	LIDOCAINA 2% GE TP OU GR	2.5900	1.3000	1.2900	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	28959	DERSANI LC TP ML	19.4000	9.7000	9.7000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	28959	DERSANI LC TP ML	19.4000	9.7000	9.7000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	33219	LUVA DE PROCEDIMENTO UNIDADE UN	1.0000	0.6700	0.3300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00817	ALGODAO HIDROFILO BOLINHA UN	0.2600	0.1300	0.1300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	11193	CLOREXIDINA 2 % ST TP ML	0.8000	0.0000	0.8000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1965b0cdebe9017c3397c8641147759	JOSE	12705413746	NULL	12705413746	08664	ESPARADRAPO MICROPORE 50 X 10 CM CM	0.5100	0.3800	0.1300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1965b0cdebe9017c3397c8641147759	JOSE	12705413746	NULL	12705413746	33227	LUVA CIRURGICA PAR UN	1.4500	0.0000	1.4500	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12558131243	NULL	12558131243	08664	ESPARADRAPO MICROPORE 50 X 10 CM CM	2.5600	0.5100	2.0500	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12558131243	NULL	12558131243	00817	ALGODAO HIDROFILO BOLINHA UN	0.5100	0.2600	0.2500	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	0.0000	3.4100	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00426	AGUA BIDESTILADA 10 ML SI IV IM AP	6.4600	0.0000	6.4600	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	37761	ALCOOL ETILICO 70 % ST TP ML	0.0300	0.0200	0.0100	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	a39fe8b0276da428395df4da4f2b1537	JOSE	12442708440	NULL	12442708440	49824	NISTATINA 100.000 UI SU VO ML	0.3000	0.2950	0.0050	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	7c2bc8cd9bbf9ce081562a3c63fff8c9	MARTA	12647505849	NULL	12647505849	22896	CEFUROXIMA 750 MG + DIL. 6 ML PO IM IV FA	26.1300	26.1250	0.0050	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	f65f553befc0e3bc8bd5bce5c1c6e413	NAIRLENE	12633078944	NULL	12633078944	33219	LUVA DE PROCEDIMENTO UNIDADE UN	1.6700	1.6650	0.0050	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	f65f553befc0e3bc8bd5bce5c1c6e413	NAIRLENE	12633078944	NULL	12633078944	19160	SERINGA DESC 20 ML UN	0.5400	0.5363	0.0037	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	f65f553befc0e3bc8bd5bce5c1c6e413	NAIRLENE	12633078944	NULL	12633078944	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4067	0.0033	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	f65f553befc0e3bc8bd5bce5c1c6e413	NAIRLENE	12633078944	NULL	12633078944	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4067	0.0033	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	f65f553befc0e3bc8bd5bce5c1c6e413	NAIRLENE	12633078944	NULL	12633078944	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1760	0.0040	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	f65f553befc0e3bc8bd5bce5c1c6e413	NAIRLENE	12633078944	NULL	12633078944	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1760	0.0040	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	f65f553befc0e3bc8bd5bce5c1c6e413	NAIRLENE	12633078944	NULL	12633078944	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1760	0.0040	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	f65f553befc0e3bc8bd5bce5c1c6e413	NAIRLENE	12633078944	NULL	12633078944	07269	DIPIRONA 500 MG/ML 2 ML SI IV IM AP	0.6900	0.6864	0.0036	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	f93cee6f501560245a8f94ffc5c6c246	ROSEDALIA	12622895145	NULL	12622895145	19160	SERINGA DESC 20 ML UN	0.5400	0.5370	0.0030	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	f93cee6f501560245a8f94ffc5c6c246	ROSEDALIA	12622895145	NULL	12622895145	19160	SERINGA DESC 20 ML UN	0.5400	0.5373	0.0027	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	026c6dcfddc3d74250c79f449289696a	SALOMAO	12456038443	NULL	12456038443	30813	DEXCLORFENIRAMINA 2 MG CP VO UN	0.3300	0.3200	0.0000	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	d4089ccef13567fd45b16fb0b60685fa	VERA	12640482546	NULL	12640482546	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1754	0.0046	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	d4089ccef13567fd45b16fb0b60685fa	VERA	12640482546	NULL	12640482546	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1754	0.0046	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	d4089ccef13567fd45b16fb0b60685fa	VERA	12640482546	NULL	12640482546	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1754	0.0046	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	d4089ccef13567fd45b16fb0b60685fa	VERA	12640482546	NULL	12640482546	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1754	0.0046	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	d4089ccef13567fd45b16fb0b60685fa	VERA	12640482546	NULL	12640482546	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1754	0.0046	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	eecb3d883747b059c3fe231c34567476	AFFRIDES	12693180144	NULL	12693180144	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4074	0.0026	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	eecb3d883747b059c3fe231c34567476	AFFRIDES	12693180144	NULL	12693180144	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4074	0.0026	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	eecb3d883747b059c3fe231c34567476	AFFRIDES	12693180144	NULL	12693180144	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4074	0.0026	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	eecb3d883747b059c3fe231c34567476	AFFRIDES	12693180144	NULL	12693180144	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4074	0.0026	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	eecb3d883747b059c3fe231c34567476	AFFRIDES	12693180144	NULL	12693180144	19160	SERINGA DESC 20 ML UN	0.5400	0.5372	0.0028	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	eecb3d883747b059c3fe231c34567476	AFFRIDES	12693180144	NULL	12693180144	19160	SERINGA DESC 20 ML UN	0.5400	0.5372	0.0028	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	eecb3d883747b059c3fe231c34567476	AFFRIDES	12693180144	NULL	12693180144	19160	SERINGA DESC 20 ML UN	0.5400	0.5372	0.0028	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	eecb3d883747b059c3fe231c34567476	AFFRIDES	12693180144	NULL	12693180144	19160	SERINGA DESC 20 ML UN	0.5400	0.5372	0.0028	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	eecb3d883747b059c3fe231c34567476	AFFRIDES	12693180144	NULL	12693180144	19160	SERINGA DESC 20 ML UN	0.5400	0.5372	0.0028	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	eecb3d883747b059c3fe231c34567476	AFFRIDES	12693180144	NULL	12693180144	19160	SERINGA DESC 20 ML UN	0.5400	0.5372	0.0028	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	eecb3d883747b059c3fe231c34567476	AFFRIDES	12693180144	NULL	12693180144	19160	SERINGA DESC 20 ML UN	0.5400	0.5372	0.0028	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	eecb3d883747b059c3fe231c34567476	AFFRIDES	12693180144	NULL	12693180144	19160	SERINGA DESC 20 ML UN	0.5400	0.5372	0.0028	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	eecb3d883747b059c3fe231c34567476	AFFRIDES	12693180144	NULL	12693180144	19160	SERINGA DESC 20 ML UN	1.0800	1.0744	0.0056	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1d6bbb4a00130e2e654e830fc9bae6a	ALEXANDRINA	12694224940	NULL	12694224940	17892	NEOSTIGMINA 0,5 MG/ML 1 ML SI SC IM IV AP	0.7700	0.7600	0.0000	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1d6bbb4a00130e2e654e830fc9bae6a	ALEXANDRINA	12694224940	NULL	12694224940	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4072	0.0028	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1d6bbb4a00130e2e654e830fc9bae6a	ALEXANDRINA	12694224940	NULL	12694224940	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4072	0.0028	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1d6bbb4a00130e2e654e830fc9bae6a	ALEXANDRINA	12694224940	NULL	12694224940	19160	SERINGA DESC 20 ML UN	0.5400	0.5367	0.0033	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1d6bbb4a00130e2e654e830fc9bae6a	ALEXANDRINA	12694224940	NULL	12694224940	19160	SERINGA DESC 20 ML UN	0.5400	0.5367	0.0033	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	345c226bfea274af1372d41b0305a6c8	ALTINO	12720257940	NULL	12720257940	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.1000	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	345c226bfea274af1372d41b0305a6c8	ALTINO	12720257940	NULL	12720257940	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.1000	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	345c226bfea274af1372d41b0305a6c8	ALTINO	12720257940	NULL	12720257940	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.1000	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.1038	-0.0038	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.1038	-0.0038	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.1038	-0.0038	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.1038	-0.0038	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.1038	-0.0038	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	19160	SERINGA DESC 20 ML UN	0.5400	0.5378	0.0022	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	19160	SERINGA DESC 20 ML UN	0.5400	0.5378	0.0022	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	19160	SERINGA DESC 20 ML UN	0.5400	0.5378	0.0022	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	19160	SERINGA DESC 20 ML UN	0.5400	0.5378	0.0022	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	19160	SERINGA DESC 20 ML UN	0.5400	0.5378	0.0022	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1797	0.0003	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1797	0.0003	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1797	0.0003	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1797	0.0003	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	00426	AGUA BIDESTILADA 10 ML SI IV IM AP	0.4000	0.4045	-0.0045	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	00426	AGUA BIDESTILADA 10 ML SI IV IM AP	0.4000	0.4045	-0.0045	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	00426	AGUA BIDESTILADA 10 ML SI IV IM AP	0.8100	0.8091	0.0009	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	20567	SORO FISIOLOGICO 0,9% 500 ML SI IV BS	4.7300	4.7350	-0.0050	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	20567	SORO FISIOLOGICO 0,9% 500 ML SI IV BS	4.7300	4.7350	-0.0050	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	20567	SORO FISIOLOGICO 0,9% 500 ML SI IV BS	4.7300	4.7350	-0.0050	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12550571048	NULL	12550571048	05975	COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER	0.3000	0.0000	0.3000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12550571048	NULL	12550571048	05975	COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER	0.3000	0.0000	0.3000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12550571048	NULL	12550571048	05975	COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER	0.3000	0.0000	0.3000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	670141098c0309ac9be3db204bdc12cf	LEOSINA	12706525442	NULL	12706525442	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1767	0.0033	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	20cbe2e07b1dcd2b6af609a50df7ae80	LUCELENA	12690767849	NULL	12690767849	27480	CLARITROMICINA 500 MG 30 ML PO IV FA	117.1100	117.1050	0.0050	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	20cbe2e07b1dcd2b6af609a50df7ae80	LUCELENA	12690767849	NULL	12690767849	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1764	0.0036	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	20cbe2e07b1dcd2b6af609a50df7ae80	LUCELENA	12690767849	NULL	12690767849	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1758	0.0042	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	20cbe2e07b1dcd2b6af609a50df7ae80	LUCELENA	12690767849	NULL	12690767849	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1758	0.0042	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	20cbe2e07b1dcd2b6af609a50df7ae80	LUCELENA	12690767849	NULL	12690767849	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1758	0.0042	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	20cbe2e07b1dcd2b6af609a50df7ae80	LUCELENA	12690767849	NULL	12690767849	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1758	0.0042	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	20cbe2e07b1dcd2b6af609a50df7ae80	LUCELENA	12690767849	NULL	12690767849	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1758	0.0042	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	20cbe2e07b1dcd2b6af609a50df7ae80	LUCELENA	12690767849	NULL	12690767849	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1758	0.0042	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	20cbe2e07b1dcd2b6af609a50df7ae80	LUCELENA	12690767849	NULL	12690767849	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4084	0.0016	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	20cbe2e07b1dcd2b6af609a50df7ae80	LUCELENA	12690767849	NULL	12690767849	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4084	0.0016	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	20cbe2e07b1dcd2b6af609a50df7ae80	LUCELENA	12690767849	NULL	12690767849	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4084	0.0016	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	20cbe2e07b1dcd2b6af609a50df7ae80	LUCELENA	12690767849	NULL	12690767849	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4084	0.0016	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	20cbe2e07b1dcd2b6af609a50df7ae80	LUCELENA	12690767849	NULL	12690767849	19160	SERINGA DESC 20 ML UN	0.5400	0.5384	0.0016	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	20cbe2e07b1dcd2b6af609a50df7ae80	LUCELENA	12690767849	NULL	12690767849	19160	SERINGA DESC 20 ML UN	0.5400	0.5384	0.0016	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	20cbe2e07b1dcd2b6af609a50df7ae80	LUCELENA	12690767849	NULL	12690767849	19160	SERINGA DESC 20 ML UN	0.5400	0.5384	0.0016	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	19445	CLORETO DE POTASSIO 600 MG CA VO UN	0.4900	0.4861	0.0039	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4075	0.0025	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4075	0.0025	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4075	0.0025	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4075	0.0025	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	07269	DIPIRONA 500 MG/ML 2 ML SI IV IM AP	0.6900	0.6865	0.0035	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	07269	DIPIRONA 500 MG/ML 2 ML SI IV IM AP	0.6900	0.6865	0.0035	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	07269	DIPIRONA 500 MG/ML 2 ML SI IV IM AP	0.6900	0.6865	0.0035	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	07269	DIPIRONA 500 MG/ML 2 ML SI IV IM AP	0.6900	0.6865	0.0035	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	07269	DIPIRONA 500 MG/ML 2 ML SI IV IM AP	0.6900	0.6865	0.0035	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	07269	DIPIRONA 500 MG/ML 2 ML SI IV IM AP	0.6900	0.6865	0.0035	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	19160	SERINGA DESC 20 ML UN	0.5400	0.5375	0.0025	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1769	0.0031	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1769	0.0031	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00426	AGUA BIDESTILADA 10 ML SI IV IM AP	0.8100	0.8073	0.0027	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	19160	SERINGA DESC 20 ML UN	0.5400	0.5372	0.0028	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	19160	SERINGA DESC 20 ML UN	0.5400	0.5372	0.0028	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	19160	SERINGA DESC 20 ML UN	0.5400	0.5372	0.0028	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	19160	SERINGA DESC 20 ML UN	0.5400	0.5372	0.0028	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1779	0.0021	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1779	0.0021	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1779	0.0021	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1900	0.1779	0.0121	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	08664	ESPARADRAPO MICROPORE 50 X 10 CM CM	0.2600	0.2558	0.0042	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	e2b254ce765be196b019032789d8f852	MARIA	12576216044	NULL	12576216044	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4076	0.0024	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	19135	SERINGA DESC 03 ML UN	0.3000	0.3000	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	19135	SERINGA DESC 03 ML UN	0.1500	0.0000	0.1500	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	d17b3c5ae418d82694895a326dee545a	ODILIA	12670516743	NULL	12670516743	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1774	0.0026	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00817	ALGODAO HIDROFILO BOLINHA UN	0.3800	0.1300	0.2500	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	6ccea6ac8c216c032723aee73a9f81c9	PRISCILA	12662249242	NULL	12662249242	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4065	0.0035	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	6ccea6ac8c216c032723aee73a9f81c9	PRISCILA	12662249242	NULL	12662249242	00426	AGUA BIDESTILADA 10 ML SI IV IM AP	0.8100	0.8075	0.0025	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	6ccea6ac8c216c032723aee73a9f81c9	PRISCILA	12662249242	NULL	12662249242	07269	DIPIRONA 500 MG/ML 2 ML SI IV IM AP	0.6900	0.6864	0.0036	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	6ccea6ac8c216c032723aee73a9f81c9	PRISCILA	12662249242	NULL	12662249242	19160	SERINGA DESC 20 ML UN	0.5400	0.5373	0.0027	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	6ccea6ac8c216c032723aee73a9f81c9	PRISCILA	12662249242	NULL	12662249242	19160	SERINGA DESC 20 ML UN	0.5400	0.5373	0.0027	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.1000	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.1000	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.1000	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.1000	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.1000	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.1000	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.1000	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.1000	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.1000	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.1000	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.1000	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.1000	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.1000	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.1000	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00426	AGUA BIDESTILADA 10 ML SI IV IM AP	0.4000	0.0000	0.4000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00426	AGUA BIDESTILADA 10 ML SI IV IM AP	1.2100	0.0000	1.2100	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	33227	LUVA CIRURGICA PAR UN	1.4500	1.4476	0.0024	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	19160	SERINGA DESC 20 ML UN	0.5400	0.5384	0.0016	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	19160	SERINGA DESC 20 ML UN	0.5400	0.5384	0.0016	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	19160	SERINGA DESC 20 ML UN	0.5400	0.5384	0.0016	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1776	0.0024	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1776	0.0024	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1776	0.0024	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1776	0.0024	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1776	0.0024	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1776	0.0024	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	53660	EQUIPO MACRO-GOTAS FLEXIVEL C/ INJETOR LATE	1.5900	1.5900	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	00426	AGUA BIDESTILADA 10 ML SI IV IM AP	0.8100	0.8092	0.0008	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	00426	AGUA BIDESTILADA 10 ML SI IV IM AP	0.8100	0.8092	0.0008	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	11193	CLOREXIDINA 2 % ST TP ML	0.5300	0.5300	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	6799aa3de305405ab065aad5b599765c	VANIR	12700232345	NULL	12700232345	07269	DIPIRONA 500 MG/ML 2 ML SI IV IM AP	0.6900	0.6870	0.0030	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	0111beed375944f60c7ad4a7fd4874f8	WALDIR	12746025744	NULL	12746025744	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1773	0.0027	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	05975	COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER	0.3000	0.0000	0.3000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00426	AGUA BIDESTILADA 10 ML SI IV IM AP	0.8100	0.8079	0.0021	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	610c198ec4c064687cf0524f147d3aed	ROBERTO	12748814743	NULL	12748814743	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1767	0.0033	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	610c198ec4c064687cf0524f147d3aed	ROBERTO	12748814743	NULL	12748814743	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1767	0.0033	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	610c198ec4c064687cf0524f147d3aed	ROBERTO	12748814743	NULL	12748814743	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4083	0.0017	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	610c198ec4c064687cf0524f147d3aed	ROBERTO	12748814743	NULL	12748814743	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4083	0.0017	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	610c198ec4c064687cf0524f147d3aed	ROBERTO	12748814743	NULL	12748814743	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4083	0.0017	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12647284040	NULL	12647284040	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1750	0.0050	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12647284040	NULL	12647284040	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4086	0.0014	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12647284040	NULL	12647284040	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4086	0.0014	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12647284040	NULL	12647284040	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4086	0.0014	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12647284040	NULL	12647284040	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4086	0.0014	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	01081195	71f5440171ef97870d290cb22b5aa301	ITAMAR	12750223317	NULL	12750223317	00010014	CONSULTA EM CONSULTORIO MEDICO	0.0000	35.0000	NULL	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	01081197	48a4767d340a20e9055db1a855afdfff	REGINA	12675950024	NULL	12675950024	32050038	TORAX PA	0.0000	11.0271	NULL	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	11193	CLOREXIDINA 2 % ST TP ML	0.8000	0.0000	0.8000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	08664	ESPARADRAPO MICROPORE 50 X 10 CM CM	0.2600	0.0000	0.2600	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	50644	MORFINA 10 MG/ML 1 ML SI IM IV PE IT AP	2.6400	2.6400	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	33545	PIPERACILINA 4 G + TAZOBACTAM 500 MG PO IV	83.4500	83.4500	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	33545	PIPERACILINA 4 G + TAZOBACTAM 500 MG PO IV	83.4500	83.4500	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	33545	PIPERACILINA 4 G + TAZOBACTAM 500 MG PO IV	83.4500	83.4500	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	6.8145	-3.4045	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	6.8145	-3.4045	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	6.8145	-3.4045	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	6.8145	-3.4045	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	6.8145	-3.4045	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	6.8145	-3.4045	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	6.8145	-3.4045	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4072	0.0028	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4072	0.0028	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4072	0.0028	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4072	0.0028	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4072	0.0028	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4072	0.0028	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4072	0.0028	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4072	0.0028	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.2120	-0.1120	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.2120	-0.1120	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	19160	SERINGA DESC 20 ML UN	0.5400	0.5374	0.0026	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	19160	SERINGA DESC 20 ML UN	0.5400	0.5374	0.0026	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	19160	SERINGA DESC 20 ML UN	0.5400	0.5374	0.0026	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	19160	SERINGA DESC 20 ML UN	0.5400	0.5374	0.0026	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	19160	SERINGA DESC 20 ML UN	0.5400	0.5374	0.0026	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	19160	SERINGA DESC 20 ML UN	0.5400	0.5374	0.0026	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	19160	SERINGA DESC 20 ML UN	0.5400	0.5374	0.0026	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00426	AGUA BIDESTILADA 10 ML SI IV IM AP	0.4000	0.4037	-0.0037	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00426	AGUA BIDESTILADA 10 ML SI IV IM AP	0.4000	0.4037	-0.0037	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00426	AGUA BIDESTILADA 10 ML SI IV IM AP	0.4000	0.4037	-0.0037	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00426	AGUA BIDESTILADA 10 ML SI IV IM AP	0.8100	0.8073	0.0027	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00426	AGUA BIDESTILADA 10 ML SI IV IM AP	0.8100	0.8073	0.0027	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00426	AGUA BIDESTILADA 10 ML SI IV IM AP	0.8100	0.8073	0.0027	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00426	AGUA BIDESTILADA 10 ML SI IV IM AP	0.8100	0.8073	0.0027	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	13757	IODOPOVIDONA SD TP ML	0.4000	0.4000	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	33219	LUVA DE PROCEDIMENTO UNIDADE UN	1.0000	1.0050	-0.0050	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	09636	FLORATIL (SACCHAROMYCES BOULARDII) 200 MG P	4.4400	8.8851	-4.4451	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	09636	FLORATIL (SACCHAROMYCES BOULARDII) 200 MG P	4.4400	8.8851	-4.4451	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	05975	COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER	0.8339	0.8679	-0.7779	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	05975	COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER	1.3129	1.3638	-0.7638	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	28959	DERSANI LC TP ML	12.6100	13.5800	-3.8800	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	55018	ALGINATO DE CALCIO EM HIDROGEL GL TP GR	3.4500	3.4500	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	55018	ALGINATO DE CALCIO EM HIDROGEL GL TP GR	58.6500	58.6500	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	08664	ESPARADRAPO MICROPORE 50 X 10 CM CM	1.3564	1.3849	-0.8749	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1d6bbb4a00130e2e654e830fc9bae6a	ALEXANDRINA	12694224940	NULL	12694224940	05274	AMOXICILINA 500 MG + CLAVULANATO 125 MG CP	3.1700	3.1667	0.0033	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	17252	LIDOCAINA 2% GE OU TP GR	NULL	0.0000	NULL	OPME INVALIDO	2201
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	51584	ESPARADRAPO MICROPORE	NULL	0.0000	NULL	OPME INVALIDO	2201
Glosa Min	2018-10-03 00:00:00.000000	1084117	800720d33fe0defb6121e82dd216d044	JALMO	12786952647	NULL	12786952647	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	800720d33fe0defb6121e82dd216d044	JALMO	12786952647	NULL	12786952647	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	800720d33fe0defb6121e82dd216d044	JALMO	12786952647	NULL	12786952647	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	800720d33fe0defb6121e82dd216d044	JALMO	12786952647	NULL	12786952647	00037	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	752c651cb4fd049e19c685f87fbe8bdc	EDUARDO	12765990646	NULL	12765990646	00172	SORO FISIOLOGICO 0,9% 500 ML SI IV BS	0.0000	9.4700	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	752c651cb4fd049e19c685f87fbe8bdc	EDUARDO	12765990646	NULL	12765990646	00172	SORO FISIOLOGICO 0,9% 500 ML SI IV BS	0.0000	9.4700	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	752c651cb4fd049e19c685f87fbe8bdc	EDUARDO	12765990646	NULL	12765990646	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.0000	0.6875	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	752c651cb4fd049e19c685f87fbe8bdc	EDUARDO	12765990646	NULL	12765990646	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.0000	0.6875	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12558131243	NULL	12558131243	00128	LUVA DE PROCEDIMENTO UNIDADE UN	0.0000	0.6680	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12558131243	NULL	12558131243	25040014	Fisioterapia Respiratória - em Doente Clínico Internado	0.0000	12.2800	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12558131243	NULL	12558131243	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.0000	1.3600	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12558131243	NULL	12558131243	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1757	NULL	VALOR APRESENTADO A MAIOR	1705
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12558131243	NULL	12558131243	52010511	Fratura do Cóccix - Tratamento Cruento	0.0000	0.0000	NULL	COBRANCA DE HONORARIOS EM DUPLICIDADE	2607
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12558131243	NULL	12558131243	52010511	Fratura do Cóccix - Tratamento Cruento	0.0000	0.0000	NULL	COBRANCA DE HONORARIOS EM DUPLICIDADE	2607
Glosa Min	2018-10-03 00:00:00.000000	1084117	526685c1041cc1316e874a2e95e67e2e	JOSE	12696604949	NULL	12696604949	00090	SERINGA DESC 20 ML UN	0.0000	0.5367	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	11232	CLEXANE (ENOXAPARINA) 40 MG SI IV SC SE	0.0000	38.9400	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	11700	EQUIPO P/ BOMBA DE INFUSAO ENTERAL / PARENTERAL	0.0000	20.2800	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	11700	EQUIPO P/ BOMBA DE INFUSAO ENTERAL / PARENTERAL	0.0000	0.0000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.0000	0.0000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.0000	0.0000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.0000	0.0000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.0000	0.0000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.0000	0.4000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.0000	0.4000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.0000	0.4000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.0000	0.4000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.0000	0.4000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	51164	AGUA BIDESTILADA 500 ML	0.0000	6.4300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	51164	AGUA BIDESTILADA 500 ML	0.0000	6.4300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.0000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.0000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	51379	SERINGA DESC 05 ML UN	0.0000	0.1900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	51379	SERINGA DESC 05 ML UN	0.0000	0.1900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	51379	SERINGA DESC 05 ML UN	0.0000	0.1900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	51379	SERINGA DESC 05 ML UN	0.0000	0.1900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	51434	BECLOMETASONA 400 MCG / ML 2 ML SL IN FL	0.0000	4.4800	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	51434	BECLOMETASONA 400 MCG / ML 2 ML SL IN FL	0.0000	4.4800	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	51434	BECLOMETASONA 400 MCG / ML 2 ML SL IN FL	0.0000	4.4800	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	51434	BECLOMETASONA 400 MCG / ML 2 ML SL IN FL	0.0000	4.4800	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	51434	BECLOMETASONA 400 MCG / ML 2 ML SL IN FL	0.0000	4.4800	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	51434	BECLOMETASONA 400 MCG / ML 2 ML SL IN FL	0.0000	4.4800	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	51434	BECLOMETASONA 400 MCG / ML 2 ML SL IN FL	0.0000	4.4800	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	51708	Dieta Hipercalorica Hiperproteica Sem Fibras 1.5 kcal	0.0000	73.4000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00613	CLINDAMICINA 600 MG 4 ML SI IM IV AP	0.0000	13.0800	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00098	ABOCATH N 14 A 22 UN	0.0000	3.7700	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	51378	SERINGA DESC 03 ML UN	0.0000	0.0000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	4e13adf421809cb755e1bdd80cc4efed	AGRIPINA	12385409142	NULL	12385409142	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.0000	0.4000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	75bcd473a0dc7c7a6751499b38a4a034	JOAQUIM	12692852143	NULL	12692852143	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4075	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	75bcd473a0dc7c7a6751499b38a4a034	JOAQUIM	12692852143	NULL	12692852143	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4075	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	75bcd473a0dc7c7a6751499b38a4a034	JOAQUIM	12692852143	NULL	12692852143	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4075	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	75bcd473a0dc7c7a6751499b38a4a034	JOAQUIM	12692852143	NULL	12692852143	01652	TRAMADOL 50 MG CP VO UN	0.0000	1.9272	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	75bcd473a0dc7c7a6751499b38a4a034	JOAQUIM	12692852143	NULL	12692852143	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.0000	0.6850	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	75bcd473a0dc7c7a6751499b38a4a034	JOAQUIM	12692852143	NULL	12692852143	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.0000	0.6850	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	75bcd473a0dc7c7a6751499b38a4a034	JOAQUIM	12692852143	NULL	12692852143	04073	TRAMADOL 50 MG 1 ML SI IM IV AP	0.0000	4.1900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	75bcd473a0dc7c7a6751499b38a4a034	JOAQUIM	12692852143	NULL	12692852143	000441	TAXA DE DELEUCOTIZAÇÃO	0.0000	0.0000	NULL	COBRANCA DE TAXAS, DE SERVICOS REALIZADOS EM AMBIENTES INCOMPATIVEIS COM O USO DE EQUIPAMENTOS	2407
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00124	LUVA CIRURGICA UN	0.0000	1.4500	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	26981	SORO FISIOLOGICO 0,9% 10 ML SI IV AP	0.0000	0.4800	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	26981	SORO FISIOLOGICO 0,9% 10 ML SI IV AP	0.0000	0.9600	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	26981	SORO FISIOLOGICO 0,9% 10 ML SI IV AP	0.0000	0.9600	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	26981	SORO FISIOLOGICO 0,9% 10 ML SI IV AP	0.0000	0.9600	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	26981	SORO FISIOLOGICO 0,9% 10 ML SI IV AP	0.0000	0.9600	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	26981	SORO FISIOLOGICO 0,9% 10 ML SI IV AP	0.0000	0.9600	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.0000	0.6900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.0000	0.6875	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	35382	COMPRESSAS DE GASES 7.5 X7,5 (11 FIOS ESTERIL) UN	0.0000	0.0900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00487	RANITIDINA 25 MG/ML 2 ML SI IM IV AP	0.0000	0.0000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00487	RANITIDINA 25 MG/ML 2 ML SI IM IV AP	0.0000	0.9300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	51578	Frasco p/ alimentacao enteral	0.0000	2.4700	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	51578	Frasco p/ alimentacao enteral	0.0000	2.4700	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	54035	LIDOCAINA 2% C/ VASO SI IM PE ML	0.0000	0.6800	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	54756	HIDANTAL	0.0000	0.1864	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	54756	HIDANTAL	0.0000	0.1864	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00796	FLORATIL (SACCHAROMYCES BOULARDII) 200 MG PO VO	0.0000	4.4400	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4088	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4088	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4088	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4088	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4088	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4088	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.0000	0.6872	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.0000	0.6872	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.0000	0.6872	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1766	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1766	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1766	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1766	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1766	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1766	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1800	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4070	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4070	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	22421	PIPERACILINA 2 G + TAZOBACTAM 250 MG 30 ML PO IV	0.0000	55.3400	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	22421	PIPERACILINA 2 G + TAZOBACTAM 250 MG 30 ML PO IV	0.0000	55.3400	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.0000	0.4000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	51584	ESPARADRAPO MICROPORE	0.0000	0.2560	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	52303	NOREPINEFRINA 2 MG/ML 4 ML SI IV AP	0.0000	9.4962	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	52303	NOREPINEFRINA 2 MG/ML 4 ML SI IV AP	0.0000	37.9900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	52537	Cateter Hemodialise Duplo Lumen 11,5fr X 20cm	0.0000	183.0000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	cd2840524be5a3f1d0939f241e24f32b	MARIA	12705908340	NULL	12705908340	00181	SULFATO DE MAGNESIO 100 MG/ML 10 ML SI IM IV	0.0000	0.9467	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	cd2840524be5a3f1d0939f241e24f32b	MARIA	12705908340	NULL	12705908340	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	cd2840524be5a3f1d0939f241e24f32b	MARIA	12705908340	NULL	12705908340	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	cd2840524be5a3f1d0939f241e24f32b	MARIA	12705908340	NULL	12705908340	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	cd2840524be5a3f1d0939f241e24f32b	MARIA	12705908340	NULL	12705908340	00090	SERINGA DESC 20 ML UN	0.0000	0.5400	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	cd2840524be5a3f1d0939f241e24f32b	MARIA	12705908340	NULL	12705908340	00090	SERINGA DESC 20 ML UN	0.0000	0.5400	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12550571048	NULL	12550571048	51659	FENOTEROL 2 MG/ML 10 ML AE IN DS	0.0000	3.4000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12550571048	NULL	12550571048	00090	SERINGA DESC 20 ML UN	0.0000	0.5379	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12550571048	NULL	12550571048	00090	SERINGA DESC 20 ML UN	0.0000	0.5379	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12550571048	NULL	12550571048	00090	SERINGA DESC 20 ML UN	0.0000	0.5379	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	9ffbbf7340bbd65e9e3baa9406d027f3	MARCO	12261811645	NULL	12261811645	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	9ffbbf7340bbd65e9e3baa9406d027f3	MARCO	12261811645	NULL	12261811645	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	9ffbbf7340bbd65e9e3baa9406d027f3	MARCO	12261811645	NULL	12261811645	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	9ffbbf7340bbd65e9e3baa9406d027f3	MARCO	12261811645	NULL	12261811645	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	9ffbbf7340bbd65e9e3baa9406d027f3	MARCO	12261811645	NULL	12261811645	01611	CLORETO DE POTASSIO 600 MG CA VO UN	0.0000	0.4867	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	9ffbbf7340bbd65e9e3baa9406d027f3	MARCO	12261811645	NULL	12261811645	01611	CLORETO DE POTASSIO 600 MG CA VO UN	0.0000	0.4867	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	9ffbbf7340bbd65e9e3baa9406d027f3	MARCO	12261811645	NULL	12261811645	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.0000	0.8100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	9ffbbf7340bbd65e9e3baa9406d027f3	MARCO	12261811645	NULL	12261811645	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.0000	0.8078	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	9ffbbf7340bbd65e9e3baa9406d027f3	MARCO	12261811645	NULL	12261811645	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.0000	0.8078	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	9ffbbf7340bbd65e9e3baa9406d027f3	MARCO	12261811645	NULL	12261811645	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.0000	0.8078	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	9ffbbf7340bbd65e9e3baa9406d027f3	MARCO	12261811645	NULL	12261811645	51208	SORO RINGER SIMPLES 500 ML SI IV BS	0.0000	5.9400	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	9ffbbf7340bbd65e9e3baa9406d027f3	MARCO	12261811645	NULL	12261811645	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1772	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	9ffbbf7340bbd65e9e3baa9406d027f3	MARCO	12261811645	NULL	12261811645	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1773	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	9ffbbf7340bbd65e9e3baa9406d027f3	MARCO	12261811645	NULL	12261811645	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1773	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	9ffbbf7340bbd65e9e3baa9406d027f3	MARCO	12261811645	NULL	12261811645	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1773	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	9ffbbf7340bbd65e9e3baa9406d027f3	MARCO	12261811645	NULL	12261811645	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1773	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	9ffbbf7340bbd65e9e3baa9406d027f3	MARCO	12261811645	NULL	12261811645	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1773	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	9ffbbf7340bbd65e9e3baa9406d027f3	MARCO	12261811645	NULL	12261811645	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1773	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	9ffbbf7340bbd65e9e3baa9406d027f3	MARCO	12261811645	NULL	12261811645	51660	BROMETO DE IPRATROPIO SL IN GT	0.0000	0.2974	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4094	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4094	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4094	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4094	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	01496	FENITOINA 50 MG/ML 5 ML SI IM IV AP	0.0000	2.3400	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	02246	HIDROCORTISONA 100 MG PO IM IV FA	0.0000	2.8300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	02246	HIDROCORTISONA 100 MG PO IM IV FA	0.0000	2.8300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	02246	HIDROCORTISONA 100 MG PO IM IV FA	0.0000	2.8300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	26981	SORO FISIOLOGICO 0,9% 10 ML SI IV AP	0.0000	0.9600	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	26981	SORO FISIOLOGICO 0,9% 10 ML SI IV AP	0.0000	0.9600	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	26981	SORO FISIOLOGICO 0,9% 10 ML SI IV AP	0.0000	0.9600	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	26981	SORO FISIOLOGICO 0,9% 10 ML SI IV AP	0.0000	0.9600	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	26981	SORO FISIOLOGICO 0,9% 10 ML SI IV AP	0.0000	0.9600	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	26981	SORO FISIOLOGICO 0,9% 10 ML SI IV AP	0.0000	0.9600	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	26981	SORO FISIOLOGICO 0,9% 10 ML SI IV AP	0.0000	0.9600	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	09070	ACETILCISTEINA 600MG PO VO SA	0.0000	3.4950	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	00091	SERINGA DESC 01 ML (INSULINA) UN	0.0000	0.3100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	15f461c0ca379f375bd9f8b18fbb101a	ANA	12753753845	NULL	12753753845	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR APRESENTADO A MAIOR	1705
Glosa Min	2018-10-03 00:00:00.000000	1084117	15f461c0ca379f375bd9f8b18fbb101a	ANA	12753753845	NULL	12753753845	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR APRESENTADO A MAIOR	1705
Glosa Min	2018-10-03 00:00:00.000000	1084117	15f461c0ca379f375bd9f8b18fbb101a	ANA	12753753845	NULL	12753753845	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	COBRANCA DE HONORARIOS EM DUPLICIDADE	2607
Glosa Min	2018-10-03 00:00:00.000000	1084117	15f461c0ca379f375bd9f8b18fbb101a	ANA	12753753845	NULL	12753753845	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.0000	0.4000	NULL	VALOR APRESENTADO A MAIOR	1705
Glosa Min	2018-10-03 00:00:00.000000	1084117	15f461c0ca379f375bd9f8b18fbb101a	ANA	12753753845	NULL	12753753845	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.0000	0.4000	NULL	VALOR APRESENTADO A MAIOR	1705
Glosa Min	2018-10-03 00:00:00.000000	1084117	15f461c0ca379f375bd9f8b18fbb101a	ANA	12753753845	NULL	12753753845	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1800	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	15f461c0ca379f375bd9f8b18fbb101a	ANA	12753753845	NULL	12753753845	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1800	NULL	VALOR APRESENTADO A MAIOR	1705
Glosa Min	2018-10-03 00:00:00.000000	1084117	15f461c0ca379f375bd9f8b18fbb101a	ANA	12753753845	NULL	12753753845	55279	TRAMADOL 50 MG 1 ML SI IM IV AP	0.0000	4.1900	NULL	COBRANCA DE MEDICAMENTO INCOMPATIVEL COM O RELATORIO TECNICO	2112
Glosa Min	2018-10-03 00:00:00.000000	1084117	15f461c0ca379f375bd9f8b18fbb101a	ANA	12753753845	NULL	12753753845	00657	CEFAZOLINA 1 GR + DIL. 10 ML PO IM IV FA	0.0000	8.1300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00124	LUVA CIRURGICA UN	0.0000	1.4475	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4072	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4072	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4072	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4072	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4072	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4072	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4072	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4072	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4072	NULL	COBRANCA DE MEDICAMENTO EM QUANTIDADE INCOMPATIVEL COM A PERMANENCIA	2107
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4072	NULL	VALOR APRESENTADO A MAIOR	1705
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4072	NULL	VALOR APRESENTADO A MAIOR	1705
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4072	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4072	NULL	VALOR APRESENTADO A MAIOR	1705
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4072	NULL	COBRANCA DE MEDICAMENTO EM QUANTIDADE INCOMPATIVEL COM A PERMANENCIA	2107
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4072	NULL	COBRANCA DE MEDICAMENTO EM QUANTIDADE INCOMPATIVEL COM A PERMANENCIA	2107
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	01611	CLORETO DE POTASSIO 600 MG CA VO UN	0.0000	0.4870	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	01611	CLORETO DE POTASSIO 600 MG CA VO UN	0.0000	0.4870	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	02355	AMOXICILINA 1 G + CLAVULANATO 200 MG + DIL. 10 ML	0.0000	36.4667	NULL	COBRANCA DE MEDICAMENTO EM QUANTIDADE INCOMPATIVEL COM A PERMANENCIA	2107
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	02355	AMOXICILINA 1 G + CLAVULANATO 200 MG + DIL. 10 ML	0.0000	36.4667	NULL	COBRANCA DE MEDICAMENTO EM QUANTIDADE INCOMPATIVEL COM A PERMANENCIA	2107
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	02355	AMOXICILINA 1 G + CLAVULANATO 200 MG + DIL. 10 ML	0.0000	36.4667	NULL	COBRANCA DE MEDICAMENTO EM QUANTIDADE INCOMPATIVEL COM A PERMANENCIA	2107
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	02355	AMOXICILINA 1 G + CLAVULANATO 200 MG + DIL. 10 ML	0.0000	36.4667	NULL	COBRANCA DE MEDICAMENTO EM QUANTIDADE INCOMPATIVEL COM A PERMANENCIA	2107
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00069	SERINGA DESC 10 ML UN	0.0000	0.6657	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00090	SERINGA DESC 20 ML UN	0.0000	0.5367	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00090	SERINGA DESC 20 ML UN	0.0000	0.5367	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00090	SERINGA DESC 20 ML UN	0.0000	0.5367	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00090	SERINGA DESC 20 ML UN	0.0000	0.5367	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00090	SERINGA DESC 20 ML UN	0.0000	0.5367	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	2e6b6f291f2df9beb1fbda6028678909	ANNA	12463693448	NULL	12463693448	00184	CLORETO DE POTASSIO 10% 10 ML SI IV AP	0.0000	0.8900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	2e6b6f291f2df9beb1fbda6028678909	ANNA	12463693448	NULL	12463693448	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1800	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00124	LUVA CIRURGICA UN	0.0000	1.4478	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00124	LUVA CIRURGICA UN	0.0000	1.4478	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00124	LUVA CIRURGICA UN	0.0000	1.4478	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.0000	0.6871	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	35382	COMPRESSAS DE GASES 7.5 X7,5 (11 FIOS ESTERIL) UN	0.0000	0.3000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00487	RANITIDINA 25 MG/ML 2 ML SI IM IV AP	0.0000	0.9300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00487	RANITIDINA 25 MG/ML 2 ML SI IM IV AP	0.0000	0.9300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00487	RANITIDINA 25 MG/ML 2 ML SI IM IV AP	0.0000	0.9300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.0000	0.4000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.0000	0.4000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.0000	0.4000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.0000	0.4000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.0000	0.4000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1776	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1776	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	51588	ESPARADRAPO MICROPORE 50 X 10 CM CM	0.0000	0.2600	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	51649	ALCOOL ETILICO 70 % ST TP ML	0.0000	0.0300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	54157	EQUIPO P/ DIETA ENTERAL UN	0.0000	1.7000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	54157	EQUIPO P/ DIETA ENTERAL UN	0.0000	1.7000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00090	SERINGA DESC 20 ML UN	0.0000	0.5375	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00090	SERINGA DESC 20 ML UN	0.0000	0.5375	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00090	SERINGA DESC 20 ML UN	0.0000	0.5375	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00090	SERINGA DESC 20 ML UN	0.0000	0.5375	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00090	SERINGA DESC 20 ML UN	0.0000	0.5375	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00096	ABOCATH N 14 A 22 UN	0.0000	3.7660	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00097	ABOCATH N 14 A 22 UN	0.0000	3.7660	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1965b0cdebe9017c3397c8641147759	JOSE	12705413746	NULL	12705413746	03280	CLOREXIDINA 2 % ST TP ML	0.0000	0.8000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1965b0cdebe9017c3397c8641147759	JOSE	12705413746	NULL	12705413746	03280	CLOREXIDINA 2 % ST TP ML	0.0000	0.8000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1965b0cdebe9017c3397c8641147759	JOSE	12705413746	NULL	12705413746	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.0000	NULL	FALTA PRESCRICAO MEDICA	1709
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1965b0cdebe9017c3397c8641147759	JOSE	12705413746	NULL	12705413746	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.0000	0.6900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1965b0cdebe9017c3397c8641147759	JOSE	12705413746	NULL	12705413746	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.0000	0.8074	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1965b0cdebe9017c3397c8641147759	JOSE	12705413746	NULL	12705413746	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.0000	0.8074	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1965b0cdebe9017c3397c8641147759	JOSE	12705413746	NULL	12705413746	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.0000	0.8074	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1965b0cdebe9017c3397c8641147759	JOSE	12705413746	NULL	12705413746	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.0000	0.8074	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1965b0cdebe9017c3397c8641147759	JOSE	12705413746	NULL	12705413746	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.0000	0.8074	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1965b0cdebe9017c3397c8641147759	JOSE	12705413746	NULL	12705413746	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1775	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1965b0cdebe9017c3397c8641147759	JOSE	12705413746	NULL	12705413746	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1775	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1965b0cdebe9017c3397c8641147759	JOSE	12705413746	NULL	12705413746	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1775	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1965b0cdebe9017c3397c8641147759	JOSE	12705413746	NULL	12705413746	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1775	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1965b0cdebe9017c3397c8641147759	JOSE	12705413746	NULL	12705413746	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1775	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1965b0cdebe9017c3397c8641147759	JOSE	12705413746	NULL	12705413746	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1775	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1965b0cdebe9017c3397c8641147759	JOSE	12705413746	NULL	12705413746	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1775	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1965b0cdebe9017c3397c8641147759	JOSE	12705413746	NULL	12705413746	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1775	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1965b0cdebe9017c3397c8641147759	JOSE	12705413746	NULL	12705413746	51584	ESPARADRAPO MICROPORE	0.0000	0.3800	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1965b0cdebe9017c3397c8641147759	JOSE	12705413746	NULL	12705413746	51584	ESPARADRAPO MICROPORE	0.0000	0.0000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1965b0cdebe9017c3397c8641147759	JOSE	12705413746	NULL	12705413746	51671	REPARIL (ESCINA + DIETILAMONIO) GL TP GR	0.0000	3.7500	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1965b0cdebe9017c3397c8641147759	JOSE	12705413746	NULL	12705413746	00090	SERINGA DESC 20 ML UN	0.0000	0.5375	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1965b0cdebe9017c3397c8641147759	JOSE	12705413746	NULL	12705413746	00090	SERINGA DESC 20 ML UN	0.0000	0.5375	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1965b0cdebe9017c3397c8641147759	JOSE	12705413746	NULL	12705413746	00090	SERINGA DESC 20 ML UN	0.0000	0.5375	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1965b0cdebe9017c3397c8641147759	JOSE	12705413746	NULL	12705413746	00090	SERINGA DESC 20 ML UN	0.0000	0.5375	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1965b0cdebe9017c3397c8641147759	JOSE	12705413746	NULL	12705413746	00090	SERINGA DESC 20 ML UN	0.0000	0.5375	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1965b0cdebe9017c3397c8641147759	JOSE	12705413746	NULL	12705413746	00090	SERINGA DESC 20 ML UN	0.0000	0.5375	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1965b0cdebe9017c3397c8641147759	JOSE	12705413746	NULL	12705413746	00090	SERINGA DESC 20 ML UN	0.0000	0.5375	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1965b0cdebe9017c3397c8641147759	JOSE	12705413746	NULL	12705413746	00090	SERINGA DESC 20 ML UN	0.0000	0.5375	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a39fe8b0276da428395df4da4f2b1537	JOSE	12442708440	NULL	12442708440	00127	LUVA DE PROCEDIMENTO UNIDADE UN	0.0000	1.6700	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a39fe8b0276da428395df4da4f2b1537	JOSE	12442708440	NULL	12442708440	00127	LUVA DE PROCEDIMENTO UNIDADE UN	0.0000	0.1664	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a39fe8b0276da428395df4da4f2b1537	JOSE	12442708440	NULL	12442708440	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a39fe8b0276da428395df4da4f2b1537	JOSE	12442708440	NULL	12442708440	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a39fe8b0276da428395df4da4f2b1537	JOSE	12442708440	NULL	12442708440	01691	NISTATINA 100.000 UI/ML SU VO ML	0.0000	0.2950	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a39fe8b0276da428395df4da4f2b1537	JOSE	12442708440	NULL	12442708440	01691	NISTATINA 100.000 UI/ML SU VO ML	0.0000	0.2950	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a39fe8b0276da428395df4da4f2b1537	JOSE	12442708440	NULL	12442708440	01691	NISTATINA 100.000 UI/ML SU VO ML	0.0000	0.2950	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a39fe8b0276da428395df4da4f2b1537	JOSE	12442708440	NULL	12442708440	20691	HIDROCORTISONA 100 MG PO IM IV FA	0.0000	2.8300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a39fe8b0276da428395df4da4f2b1537	JOSE	12442708440	NULL	12442708440	20691	HIDROCORTISONA 100 MG PO IM IV FA	0.0000	2.8300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a39fe8b0276da428395df4da4f2b1537	JOSE	12442708440	NULL	12442708440	04963	PANTOPRAZOL 40 MG CP VO UN	0.0000	3.4600	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a39fe8b0276da428395df4da4f2b1537	JOSE	12442708440	NULL	12442708440	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1765	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a39fe8b0276da428395df4da4f2b1537	JOSE	12442708440	NULL	12442708440	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1765	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a39fe8b0276da428395df4da4f2b1537	JOSE	12442708440	NULL	12442708440	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1765	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a39fe8b0276da428395df4da4f2b1537	JOSE	12442708440	NULL	12442708440	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1800	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a39fe8b0276da428395df4da4f2b1537	JOSE	12442708440	NULL	12442708440	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1765	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a39fe8b0276da428395df4da4f2b1537	JOSE	12442708440	NULL	12442708440	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1765	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a39fe8b0276da428395df4da4f2b1537	JOSE	12442708440	NULL	12442708440	51241	AGULHA 123X45	0.0000	0.1900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a39fe8b0276da428395df4da4f2b1537	JOSE	12442708440	NULL	12442708440	51241	AGULHA 123X45	0.0000	0.1900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a39fe8b0276da428395df4da4f2b1537	JOSE	12442708440	NULL	12442708440	51241	AGULHA 123X45	0.0000	0.1900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a39fe8b0276da428395df4da4f2b1537	JOSE	12442708440	NULL	12442708440	51241	AGULHA 123X45	0.0000	0.1900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a39fe8b0276da428395df4da4f2b1537	JOSE	12442708440	NULL	12442708440	51241	AGULHA 123X45	0.0000	0.1900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a39fe8b0276da428395df4da4f2b1537	JOSE	12442708440	NULL	12442708440	00090	SERINGA DESC 20 ML UN	0.0000	0.5373	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a39fe8b0276da428395df4da4f2b1537	JOSE	12442708440	NULL	12442708440	00090	SERINGA DESC 20 ML UN	0.0000	0.5373	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a39fe8b0276da428395df4da4f2b1537	JOSE	12442708440	NULL	12442708440	00090	SERINGA DESC 20 ML UN	0.0000	0.5373	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a39fe8b0276da428395df4da4f2b1537	JOSE	12442708440	NULL	12442708440	00090	SERINGA DESC 20 ML UN	0.0000	0.5373	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a39fe8b0276da428395df4da4f2b1537	JOSE	12442708440	NULL	12442708440	00090	SERINGA DESC 20 ML UN	0.0000	0.5373	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a39fe8b0276da428395df4da4f2b1537	JOSE	12442708440	NULL	12442708440	00919	ALGODAO HIDROFILO BOLINHA UN	0.0000	0.0400	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	61e4786d45edfdbf19b77fb2c6ce6b9c	REINALDO	12754482747	NULL	12754482747	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	61e4786d45edfdbf19b77fb2c6ce6b9c	REINALDO	12754482747	NULL	12754482747	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	61e4786d45edfdbf19b77fb2c6ce6b9c	REINALDO	12754482747	NULL	12754482747	00172	SORO FISIOLOGICO 0,9% 500 ML SI IV BS	0.0000	4.7300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	61e4786d45edfdbf19b77fb2c6ce6b9c	REINALDO	12754482747	NULL	12754482747	00172	SORO FISIOLOGICO 0,9% 500 ML SI IV BS	0.0000	4.7300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	61e4786d45edfdbf19b77fb2c6ce6b9c	REINALDO	12754482747	NULL	12754482747	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	61e4786d45edfdbf19b77fb2c6ce6b9c	REINALDO	12754482747	NULL	12754482747	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	61e4786d45edfdbf19b77fb2c6ce6b9c	REINALDO	12754482747	NULL	12754482747	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	61e4786d45edfdbf19b77fb2c6ce6b9c	REINALDO	12754482747	NULL	12754482747	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.0000	0.6900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	61e4786d45edfdbf19b77fb2c6ce6b9c	REINALDO	12754482747	NULL	12754482747	04073	TRAMADOL 50 MG 1 ML SI IM IV AP	0.0000	4.1900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	61e4786d45edfdbf19b77fb2c6ce6b9c	REINALDO	12754482747	NULL	12754482747	00487	RANITIDINA 25 MG/ML 2 ML SI IM IV AP	0.0000	0.9300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	61e4786d45edfdbf19b77fb2c6ce6b9c	REINALDO	12754482747	NULL	12754482747	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.0000	0.4000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	61e4786d45edfdbf19b77fb2c6ce6b9c	REINALDO	12754482747	NULL	12754482747	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.0000	0.4000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	61e4786d45edfdbf19b77fb2c6ce6b9c	REINALDO	12754482747	NULL	12754482747	51379	SERINGA DESC 05 ML UN	0.0000	0.3800	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	61e4786d45edfdbf19b77fb2c6ce6b9c	REINALDO	12754482747	NULL	12754482747	51589	ESPARADRAPO 10 X 4.5 CM CM	0.0000	0.4000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	61e4786d45edfdbf19b77fb2c6ce6b9c	REINALDO	12754482747	NULL	12754482747	51649	ALCOOL ETILICO 70 % ST TP ML	0.0000	0.0300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	61e4786d45edfdbf19b77fb2c6ce6b9c	REINALDO	12754482747	NULL	12754482747	51649	ALCOOL ETILICO 70 % ST TP ML	0.0000	0.0300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	61e4786d45edfdbf19b77fb2c6ce6b9c	REINALDO	12754482747	NULL	12754482747	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	102001	DIARIA DE APARTAMENTO	0.0000	288.8880	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4072	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4072	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4072	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4072	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4072	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4072	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	00090	SERINGA DESC 20 ML UN	0.0000	0.5371	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	00090	SERINGA DESC 20 ML UN	0.0000	0.5371	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	00090	SERINGA DESC 20 ML UN	0.0000	0.5371	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	00090	SERINGA DESC 20 ML UN	0.0000	0.5371	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	00090	SERINGA DESC 20 ML UN	0.0000	0.5371	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	00919	ALGODAO HIDROFILO BOLINHA UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	081fdadb830fb547e83c43fabdb88372	ELZA	12377335349	NULL	12377335349	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	081fdadb830fb547e83c43fabdb88372	ELZA	12377335349	NULL	12377335349	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	081fdadb830fb547e83c43fabdb88372	ELZA	12377335349	NULL	12377335349	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	081fdadb830fb547e83c43fabdb88372	ELZA	12377335349	NULL	12377335349	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	081fdadb830fb547e83c43fabdb88372	ELZA	12377335349	NULL	12377335349	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	081fdadb830fb547e83c43fabdb88372	ELZA	12377335349	NULL	12377335349	01611	CLORETO DE POTASSIO 600 MG CA VO UN	0.0000	0.4900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	081fdadb830fb547e83c43fabdb88372	ELZA	12377335349	NULL	12377335349	01611	CLORETO DE POTASSIO 600 MG CA VO UN	0.0000	0.4900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	081fdadb830fb547e83c43fabdb88372	ELZA	12377335349	NULL	12377335349	01611	CLORETO DE POTASSIO 600 MG CA VO UN	0.0000	0.4900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	081fdadb830fb547e83c43fabdb88372	ELZA	12377335349	NULL	12377335349	02246	HIDROCORTISONA 100 MG PO IM IV FA	0.0000	5.6700	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	081fdadb830fb547e83c43fabdb88372	ELZA	12377335349	NULL	12377335349	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1800	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	081fdadb830fb547e83c43fabdb88372	ELZA	12377335349	NULL	12377335349	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1800	NULL	PAGO CONFORME RELATORIO DE AUDITORIA EXTERNA ― CONTA INICIAL	1717
Glosa Min	2018-10-03 00:00:00.000000	1084117	081fdadb830fb547e83c43fabdb88372	ELZA	12377335349	NULL	12377335349	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1800	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	081fdadb830fb547e83c43fabdb88372	ELZA	12377335349	NULL	12377335349	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1800	NULL	PAGO CONFORME RELATORIO DE AUDITORIA EXTERNA ― CONTA INICIAL	1717
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.0000	0.6860	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	51379	SERINGA DESC 05 ML UN	0.0000	0.1900	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	51379	SERINGA DESC 05 ML UN	0.0000	0.1900	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	51379	SERINGA DESC 05 ML UN	0.0000	0.1900	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	345c226bfea274af1372d41b0305a6c8	ALTINO	12720257940	NULL	12720257940	00493	BROMOPRIDA 5 MG/ML 2 ML SI IM IV AP	0.0000	2.7300	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	345c226bfea274af1372d41b0305a6c8	ALTINO	12720257940	NULL	12720257940	00090	SERINGA DESC 20 ML UN	0.0000	0.5367	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	dd486d36a88cfef0b44fe652638a0164	DELFINA	12660326244	NULL	12660326244	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	dd486d36a88cfef0b44fe652638a0164	DELFINA	12660326244	NULL	12660326244	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	dd486d36a88cfef0b44fe652638a0164	DELFINA	12660326244	NULL	12660326244	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	dd486d36a88cfef0b44fe652638a0164	DELFINA	12660326244	NULL	12660326244	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	dd486d36a88cfef0b44fe652638a0164	DELFINA	12660326244	NULL	12660326244	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	dd486d36a88cfef0b44fe652638a0164	DELFINA	12660326244	NULL	12660326244	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	dd486d36a88cfef0b44fe652638a0164	DELFINA	12660326244	NULL	12660326244	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	dd486d36a88cfef0b44fe652638a0164	DELFINA	12660326244	NULL	12660326244	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	dd486d36a88cfef0b44fe652638a0164	DELFINA	12660326244	NULL	12660326244	00090	SERINGA DESC 20 ML UN	0.0000	0.5400	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	dd486d36a88cfef0b44fe652638a0164	DELFINA	12660326244	NULL	12660326244	00090	SERINGA DESC 20 ML UN	0.0000	0.5400	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	dd486d36a88cfef0b44fe652638a0164	DELFINA	12660326244	NULL	12660326244	00090	SERINGA DESC 20 ML UN	0.0000	0.5400	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	dd486d36a88cfef0b44fe652638a0164	DELFINA	12660326244	NULL	12660326244	00090	SERINGA DESC 20 ML UN	0.0000	0.5400	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	dd486d36a88cfef0b44fe652638a0164	DELFINA	12660326244	NULL	12660326244	00090	SERINGA DESC 20 ML UN	0.0000	0.5400	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	dd486d36a88cfef0b44fe652638a0164	DELFINA	12660326244	NULL	12660326244	00090	SERINGA DESC 20 ML UN	0.0000	0.5400	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	dd486d36a88cfef0b44fe652638a0164	DELFINA	12660326244	NULL	12660326244	00919	ALGODAO HIDROFILO BOLINHA UN	0.0000	0.2600	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	01652	TRAMADOL 50 MG CP VO UN	0.0000	1.9300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	00184	CLORETO DE POTASSIO 10% 10 ML SI IV AP	0.0000	0.5900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.0000	0.6900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.0000	0.6875	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.0000	0.6875	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.0000	0.6900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.0000	0.6900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.0000	0.6900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.0000	0.6900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	35382	COMPRESSAS DE GASES 7.5 X7,5 (11 FIOS ESTERIL) UN	0.0000	0.3000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1800	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1800	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	51588	ESPARADRAPO MICROPORE 50 X 10 CM CM	0.0000	0.5100	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	51589	ESPARADRAPO 10 X 4.5 CM CM	0.0000	0.4000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	51589	ESPARADRAPO 10 X 4.5 CM CM	0.0000	0.4000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	51589	ESPARADRAPO 10 X 4.5 CM CM	0.0000	0.4000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	610c198ec4c064687cf0524f147d3aed	ROBERTO	12748814743	NULL	12748814743	16322	BENZILPENICILINA POTASSICA CRIST. 5.000.000	8.0700	8.0683	0.0017	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	610c198ec4c064687cf0524f147d3aed	ROBERTO	12748814743	NULL	12748814743	16322	BENZILPENICILINA POTASSICA CRIST. 5.000.000	8.0700	8.0683	0.0017	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	610c198ec4c064687cf0524f147d3aed	ROBERTO	12748814743	NULL	12748814743	16322	BENZILPENICILINA POTASSICA CRIST. 5.000.000	8.0700	8.0683	0.0017	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	51378	SERINGA DESC 03 ML UN	0.1500	0.0600	0.0900	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	51378	SERINGA DESC 03 ML UN	0.1500	0.0600	0.0900	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	51378	SERINGA DESC 03 ML UN	0.1500	0.0600	0.0900	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	51378	SERINGA DESC 03 ML UN	0.1500	0.0600	0.0900	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	03280	CLOREXIDINA 2 % ST TP ML	0.2700	0.1100	0.1600	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	03280	CLOREXIDINA 2 % ST TP ML	0.2700	0.1100	0.1600	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00091	SERINGA DESC 01 ML (INSULINA) UN	0.3100	0.1300	0.1800	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00127	LUVA DE PROCEDIMENTO UNIDADE UN	0.3300	0.1300	0.2000	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00127	LUVA DE PROCEDIMENTO UNIDADE UN	0.3300	0.1300	0.2000	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.4000	0.1600	0.2400	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.4000	0.1600	0.2400	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.4000	0.1600	0.2400	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.4000	0.1600	0.2400	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.4000	0.1600	0.2400	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.4000	0.1600	0.2400	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.4000	0.1600	0.2400	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.4000	0.1600	0.2400	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.4000	0.1600	0.2400	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.4000	0.1600	0.2400	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.4000	0.1600	0.2400	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.4000	0.1600	0.2400	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	54687	IODOPOVIDONA SD TP ML	0.4000	0.1600	0.2400	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00020010	Visita Hospitalar (Paciente Internado)	43.8000	17.1000	26.7000	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	000441	TAXA DE DELEUCOTIZAÇÃO	150.9000	58.9300	91.9700	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	01081197	e0b1f77dc9cff210f2fbead99c7ba4d4	MARCIO	12790052920	NULL	12790052920	00943	EQUIPO POLIFIX 2 VIAS UN	NULL	0.0000	NULL	OPME INVALIDO	2201
Glosa Min	2018-10-03 00:00:00.000000	01081197	3af14fcc4f764a77ed38b3d2e81bcc76	JOAO	12687535922	NULL	12687535922	00943	EQUIPO POLIFIX 2 VIAS UN	NULL	0.0000	NULL	OPME INVALIDO	2201
Glosa Min	2018-10-03 00:00:00.000000	1084117	16b1e9f62f247f02ad5cac910ee15b4e	BERCHOLINA	12631612848	NULL	12631612848	04073	TRAMADOL 50 MG 1 ML SI IM IV AP	4.1900	4.0000	0.1900	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	16b1e9f62f247f02ad5cac910ee15b4e	BERCHOLINA	12631612848	NULL	12631612848	04073	TRAMADOL 50 MG 1 ML SI IM IV AP	4.1900	4.0000	0.1900	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	16b1e9f62f247f02ad5cac910ee15b4e	BERCHOLINA	12631612848	NULL	12631612848	04073	TRAMADOL 50 MG 1 ML SI IM IV AP	4.1900	4.0000	0.1900	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	16b1e9f62f247f02ad5cac910ee15b4e	BERCHOLINA	12631612848	NULL	12631612848	04073	TRAMADOL 50 MG 1 ML SI IM IV AP	4.1900	4.0000	0.1900	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	16b1e9f62f247f02ad5cac910ee15b4e	BERCHOLINA	12631612848	NULL	12631612848	04073	TRAMADOL 50 MG 1 ML SI IM IV AP	4.1900	4.0000	0.1900	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	16b1e9f62f247f02ad5cac910ee15b4e	BERCHOLINA	12631612848	NULL	12631612848	04073	TRAMADOL 50 MG 1 ML SI IM IV AP	4.1900	3.9900	0.2000	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	16b1e9f62f247f02ad5cac910ee15b4e	BERCHOLINA	12631612848	NULL	12631612848	00020010	Visita Hospitalar (Paciente Internado)	43.8000	41.7400	2.0600	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	16b1e9f62f247f02ad5cac910ee15b4e	BERCHOLINA	12631612848	NULL	12631612848	20080	LINEZOLIDA 2 MG/ML 300 ML SI IV BS	174.9800	166.7800	8.2000	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	16b1e9f62f247f02ad5cac910ee15b4e	BERCHOLINA	12631612848	NULL	12631612848	20080	LINEZOLIDA 2 MG/ML 300 ML SI IV BS	174.9800	166.7800	8.2000	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	16b1e9f62f247f02ad5cac910ee15b4e	BERCHOLINA	12631612848	NULL	12631612848	20080	LINEZOLIDA 2 MG/ML 300 ML SI IV BS	174.9800	166.7800	8.2000	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	01081195	97f5f60aa3185a946dfdacc2f35b3424	MARIA	12690770218	NULL	12690770218	00010014	CONSULTA EM CONSULTORIO MEDICO	0.0000	0.0000	50.0000	GUIA DE CONSULTA NAO EXECUTADA	0622
Glosa Min	2018-10-03 00:00:00.000000	01081195	cd8240dfed3b190f93e1f35f15f53916	WANDELCY	12811021118	NULL	12811021118	00010014	CONSULTA EM CONSULTORIO MEDICO	0.0000	0.0000	50.0000	GUIA DE CONSULTA NAO EXECUTADA	0622
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12579183644	NULL	12579183644	08648	ESPARADRAPO 10 X 4.5 CM CM	0.4000	0.2000	0.2000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12579183644	NULL	12579183644	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.3500	0.0000	0.3500	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12579183644	NULL	12579183644	08648	ESPARADRAPO 10 X 4.5 CM CM	0.4000	0.2600	0.1400	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12579183644	NULL	12579183644	32204	CLORETO DE SODIO 0,9% 10 ML SI IV AP	0.9600	0.0000	0.9600	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12579183644	NULL	12579183644	02720	BOLSA COLETORA (SISTEMA ABERTO) UN	1.2800	0.6400	0.6400	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12579183644	NULL	12579183644	37761	ALCOOL ETILICO 70 % ST TP ML	0.0600	0.0300	0.0300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12579183644	NULL	12579183644	32204	CLORETO DE SODIO 0,9% 10 ML SI IV AP	0.9600	0.0000	0.9600	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12579183644	NULL	12579183644	28959	DERSANI LC TP ML	19.4000	14.5500	4.8500	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12579183644	NULL	12579183644	00817	ALGODAO HIDROFILO BOLINHA UN	0.5100	0.2600	0.2500	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	d17b3c5ae418d82694895a326dee545a	ODILIA	12670516743	NULL	12670516743	00817	ALGODAO HIDROFILO BOLINHA UN	0.2600	0.1300	0.1300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	d17b3c5ae418d82694895a326dee545a	ODILIA	12670516743	NULL	12670516743	00817	ALGODAO HIDROFILO BOLINHA UN	0.2600	0.1300	0.1300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	d17b3c5ae418d82694895a326dee545a	ODILIA	12670516743	NULL	12670516743	30376	BROMETO DE IPRATROPIO 0,25MG/ML SL IN GT	0.6000	0.0000	0.6000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	20cbe2e07b1dcd2b6af609a50df7ae80	LUCELENA	12690767849	NULL	12690767849	00817	ALGODAO HIDROFILO BOLINHA UN	0.2600	0.1300	0.1300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	20cbe2e07b1dcd2b6af609a50df7ae80	LUCELENA	12690767849	NULL	12690767849	37761	ALCOOL ETILICO 70 % ST TP ML	0.0300	0.0200	0.0100	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	20cbe2e07b1dcd2b6af609a50df7ae80	LUCELENA	12690767849	NULL	12690767849	32891	EQUIPO POLIFIX 2ş VIAS UN	7.6500	0.0000	7.6500	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	20cbe2e07b1dcd2b6af609a50df7ae80	LUCELENA	12690767849	NULL	12690767849	53660	EQUIPO MACRO-GOTAS FLEXIVEL C/ INJETOR LATE	4.7700	0.0000	4.7700	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	526685c1041cc1316e874a2e95e67e2e	JOSE	12696604949	NULL	12696604949	57495	FILTRO BARREIRA E REGENERADOR DE CALOR E UM	24.0000	0.0000	24.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	02720	BOLSA COLETORA (SISTEMA ABERTO) UN	1.2800	0.9600	0.3200	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	02720	BOLSA COLETORA (SISTEMA ABERTO) UN	1.2800	0.9600	0.3200	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	08460	EQUIPO P/ SOLUÇOES FOTOSSENSIVEIS UN	16.4000	0.0000	16.4000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	00817	ALGODAO HIDROFILO BOLINHA UN	0.5100	0.2600	0.2500	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	19160	SERINGA DESC 20 ML UN	0.5400	0.0000	0.5400	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00817	ALGODAO HIDROFILO BOLINHA UN	0.2600	0.1300	0.1300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	33219	LUVA DE PROCEDIMENTO UNIDADE UN	1.0000	0.6700	0.3300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00817	ALGODAO HIDROFILO BOLINHA UN	0.5100	0.2600	0.2500	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	08664	ESPARADRAPO MICROPORE 50 X 10 CM CM	0.7700	0.2600	0.5100	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00817	ALGODAO HIDROFILO BOLINHA UN	0.5100	0.2600	0.2500	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	20621	SORO GLICOSADO 5% 500 ML SI IV BS	5.1900	0.0000	5.1900	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00426	AGUA BIDESTILADA 10 ML SI IV IM AP	0.8100	0.0000	0.8100	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00817	ALGODAO HIDROFILO BOLINHA UN	0.5100	0.2600	0.2500	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	22748	LIDOCAINA 2% GE TP OU GR	7.7800	5.1900	2.5900	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	37761	ALCOOL ETILICO 70 % ST TP ML	0.0600	0.0300	0.0300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00035	ABOCATH (CATETER INTRAVENOSO) N. 14 A 22 UN	3.7700	0.0000	3.7700	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	37761	ALCOOL ETILICO 70 % ST TP ML	0.0600	0.0300	0.0300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	752c651cb4fd049e19c685f87fbe8bdc	EDUARDO	12765990646	NULL	12765990646	55654	GLIMEPIRIDA 2 MG CP VO UN	1.0200	0.0000	1.0200	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	752c651cb4fd049e19c685f87fbe8bdc	EDUARDO	12765990646	NULL	12765990646	00817	ALGODAO HIDROFILO BOLINHA UN	0.2600	0.1300	0.1300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	752c651cb4fd049e19c685f87fbe8bdc	EDUARDO	12765990646	NULL	12765990646	25739	ELETRODO DESCARTAVEL (UTI) UN	4.6100	0.0000	4.6100	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	752c651cb4fd049e19c685f87fbe8bdc	EDUARDO	12765990646	NULL	12765990646	00817	ALGODAO HIDROFILO BOLINHA UN	0.5100	0.1300	0.3800	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	752c651cb4fd049e19c685f87fbe8bdc	EDUARDO	12765990646	NULL	12765990646	37761	ALCOOL ETILICO 70 % ST TP ML	0.0600	0.0200	0.0400	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	752c651cb4fd049e19c685f87fbe8bdc	EDUARDO	12765990646	NULL	12765990646	53660	EQUIPO MACRO-GOTAS FLEXIVEL C/ INJETOR LATE	1.5900	0.0000	1.5900	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	37761	ALCOOL ETILICO 70 % ST TP ML	0.0300	0.0200	0.0100	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00817	ALGODAO HIDROFILO BOLINHA UN	0.2600	0.1300	0.1300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	02461	FENOTEROL 2 MG/ML 10 ML AE IN DS	2.5500	0.0000	2.5500	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	345c226bfea274af1372d41b0305a6c8	ALTINO	12720257940	NULL	12720257940	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.1000	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	345c226bfea274af1372d41b0305a6c8	ALTINO	12720257940	NULL	12720257940	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.1000	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	345c226bfea274af1372d41b0305a6c8	ALTINO	12720257940	NULL	12720257940	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.1000	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	345c226bfea274af1372d41b0305a6c8	ALTINO	12720257940	NULL	12720257940	07269	DIPIRONA 500 MG/ML 2 ML SI IV IM AP	0.6900	0.6860	0.0040	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	345c226bfea274af1372d41b0305a6c8	ALTINO	12720257940	NULL	12720257940	07269	DIPIRONA 500 MG/ML 2 ML SI IV IM AP	0.6900	0.6860	0.0040	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	345c226bfea274af1372d41b0305a6c8	ALTINO	12720257940	NULL	12720257940	07269	DIPIRONA 500 MG/ML 2 ML SI IV IM AP	0.6900	0.6860	0.0040	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	0405a686318e3fc262f105ed4be24d95	CARMELITA	12687161644	NULL	12687161644	08664	ESPARADRAPO MICROPORE 50 X 10 CM CM	0.2600	0.2500	0.0000	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	0405a686318e3fc262f105ed4be24d95	CARMELITA	12687161644	NULL	12687161644	07269	DIPIRONA 500 MG/ML 2 ML SI IV IM AP	0.6900	0.6873	0.0027	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	0405a686318e3fc262f105ed4be24d95	CARMELITA	12687161644	NULL	12687161644	07269	DIPIRONA 500 MG/ML 2 ML SI IV IM AP	0.6900	0.6873	0.0027	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	0405a686318e3fc262f105ed4be24d95	CARMELITA	12687161644	NULL	12687161644	19160	SERINGA DESC 20 ML UN	0.5400	0.5364	0.0036	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	0405a686318e3fc262f105ed4be24d95	CARMELITA	12687161644	NULL	12687161644	19160	SERINGA DESC 20 ML UN	0.5400	0.5367	0.0033	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	0405a686318e3fc262f105ed4be24d95	CARMELITA	12687161644	NULL	12687161644	19160	SERINGA DESC 20 ML UN	1.0800	1.0733	0.0067	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	752c651cb4fd049e19c685f87fbe8bdc	EDUARDO	12765990646	NULL	12765990646	00817	ALGODAO HIDROFILO BOLINHA UN	0.1300	0.0000	0.1300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1900	0.1850	0.0050	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	11193	CLOREXIDINA 2 % ST TP ML	0.8000	0.2700	0.5300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1900	0.1850	0.0050	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	00426	AGUA BIDESTILADA 10 ML SI IV IM AP	0.8100	0.8075	0.0025	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	11193	CLOREXIDINA 2 % ST TP ML	0.8000	0.7972	0.0028	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	01081195	c0b17ac489b9ddf5461f07299a83811a	HERMIONE	12812138714	NULL	12812138714	00010014	CONSULTA EM CONSULTORIO MEDICO	0.0000	35.0000	NULL	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	20672	SORO RINGER SIMPLES 500 ML SI IV BS	5.9400	5.9367	0.0033	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	08648	ESPARADRAPO 10 X 4.5 CM CM	0.4000	0.0000	0.4000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	02720	BOLSA COLETORA (SISTEMA ABERTO) UN	1.2800	0.9600	0.3200	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	00817	ALGODAO HIDROFILO BOLINHA UN	0.5100	0.2600	0.2500	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	02720	BOLSA COLETORA (SISTEMA ABERTO) UN	1.2800	0.9600	0.3200	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	00817	ALGODAO HIDROFILO BOLINHA UN	0.5100	0.2600	0.2500	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	31d18d6607d9e742c53e748d6a55d740	CARLOS	12557779343	NULL	12557779343	08648	ESPARADRAPO 10 X 4.5 CM CM	2.0000	1.2800	0.7200	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	31d18d6607d9e742c53e748d6a55d740	CARLOS	12557779343	NULL	12557779343	33219	LUVA DE PROCEDIMENTO UNIDADE UN	3.3300	1.6700	1.6600	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	31d18d6607d9e742c53e748d6a55d740	CARLOS	12557779343	NULL	12557779343	27545	CAMPO IODOFORADO UN	96.8000	0.0000	96.8000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	31d18d6607d9e742c53e748d6a55d740	CARLOS	12557779343	NULL	12557779343	08664	ESPARADRAPO MICROPORE 50 X 10 CM CM	0.7700	0.2600	0.5100	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	31d18d6607d9e742c53e748d6a55d740	CARLOS	12557779343	NULL	12557779343	08664	ESPARADRAPO MICROPORE 50 X 10 CM CM	0.7700	0.2600	0.5100	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	00817	ALGODAO HIDROFILO BOLINHA UN	0.2600	0.1300	0.1300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	33219	LUVA DE PROCEDIMENTO UNIDADE UN	1.6700	0.6700	1.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	00817	ALGODAO HIDROFILO BOLINHA UN	0.2600	0.1300	0.1300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	33219	LUVA DE PROCEDIMENTO UNIDADE UN	1.0000	0.6700	0.3300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	31348	NIFEDIPINA 10 MG CA VO UN	0.3900	0.0000	0.3900	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	9ffbbf7340bbd65e9e3baa9406d027f3	MARCO	12261811645	NULL	12261811645	00817	ALGODAO HIDROFILO BOLINHA UN	0.2600	0.1300	0.1300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	9ffbbf7340bbd65e9e3baa9406d027f3	MARCO	12261811645	NULL	12261811645	33219	LUVA DE PROCEDIMENTO UNIDADE UN	1.0000	0.6700	0.3300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	9ffbbf7340bbd65e9e3baa9406d027f3	MARCO	12261811645	NULL	12261811645	37761	ALCOOL ETILICO 70 % ST TP ML	0.0300	0.0200	0.0100	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	9ffbbf7340bbd65e9e3baa9406d027f3	MARCO	12261811645	NULL	12261811645	00817	ALGODAO HIDROFILO BOLINHA UN	0.2600	0.1300	0.1300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	9ffbbf7340bbd65e9e3baa9406d027f3	MARCO	12261811645	NULL	12261811645	00035	ABOCATH (CATETER INTRAVENOSO) N. 14 A 22 UN	3.7700	0.0000	3.7700	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	9ffbbf7340bbd65e9e3baa9406d027f3	MARCO	12261811645	NULL	12261811645	30376	BROMETO DE IPRATROPIO 0,25MG/ML SL IN GT	0.4000	0.0000	0.4000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	9ffbbf7340bbd65e9e3baa9406d027f3	MARCO	12261811645	NULL	12261811645	02461	FENOTEROL 2 MG/ML 10 ML AE IN DS	0.2600	0.0000	0.2600	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	9ffbbf7340bbd65e9e3baa9406d027f3	MARCO	12261811645	NULL	12261811645	00817	ALGODAO HIDROFILO BOLINHA UN	0.2600	0.1300	0.1300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	9ffbbf7340bbd65e9e3baa9406d027f3	MARCO	12261811645	NULL	12261811645	02461	FENOTEROL 2 MG/ML 10 ML AE IN DS	1.5300	0.0000	1.5300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	9ffbbf7340bbd65e9e3baa9406d027f3	MARCO	12261811645	NULL	12261811645	02461	FENOTEROL 2 MG/ML 10 ML AE IN DS	0.2600	0.0000	0.2600	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	d4089ccef13567fd45b16fb0b60685fa	VERA	12656425943	NULL	12656425943	33219	LUVA DE PROCEDIMENTO UNIDADE UN	1.0000	0.3300	0.6700	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	edffb7fef608512400078fdf75991573	CARLA	12728631049	NULL	12728631049	57495	FILTRO BARREIRA E REGENERADOR DE CALOR E UM	24.0000	0.0000	24.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	00817	ALGODAO HIDROFILO BOLINHA UN	0.5100	0.2600	0.2500	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	cd2840524be5a3f1d0939f241e24f32b	MARIA	12705908340	NULL	12705908340	37761	ALCOOL ETILICO 70 % ST TP ML	0.0300	0.0200	0.0100	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	cd2840524be5a3f1d0939f241e24f32b	MARIA	12705908340	NULL	12705908340	00817	ALGODAO HIDROFILO BOLINHA UN	0.2600	0.1300	0.1300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	cd2840524be5a3f1d0939f241e24f32b	MARIA	12705908340	NULL	12705908340	37761	ALCOOL ETILICO 70 % ST TP ML	0.0300	0.0200	0.0100	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	cd2840524be5a3f1d0939f241e24f32b	MARIA	12705908340	NULL	12705908340	33219	LUVA DE PROCEDIMENTO UNIDADE UN	1.0000	0.6700	0.3300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	cd2840524be5a3f1d0939f241e24f32b	MARIA	12705908340	NULL	12705908340	37761	ALCOOL ETILICO 70 % ST TP ML	0.0300	0.0200	0.0100	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12603877940	NULL	12603877940	33219	LUVA DE PROCEDIMENTO UNIDADE UN	2.6600	0.6700	1.9900	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12603877940	NULL	12603877940	00426	AGUA BIDESTILADA 10 ML SI IV IM AP	2.4200	2.0200	0.4000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12603877940	NULL	12603877940	37761	ALCOOL ETILICO 70 % ST TP ML	0.0300	0.0200	0.0100	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12603877940	NULL	12603877940	11193	CLOREXIDINA 2 % ST TP ML	2.1300	1.3300	0.8000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12603877940	NULL	12603877940	33219	LUVA DE PROCEDIMENTO UNIDADE UN	3.6600	0.6700	2.9900	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12603877940	NULL	12603877940	33219	LUVA DE PROCEDIMENTO UNIDADE UN	1.6700	0.6700	1.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12603877940	NULL	12603877940	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.3100	0.2100	0.1000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12603877940	NULL	12603877940	19151	SERINGA DESC 10 ML UN	1.0000	0.6700	0.3300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12603877940	NULL	12603877940	33227	LUVA CIRURGICA PAR UN	8.6900	7.2400	1.4500	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12603877940	NULL	12603877940	33227	LUVA CIRURGICA PAR UN	8.6900	5.7900	2.9000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	33219	LUVA DE PROCEDIMENTO UNIDADE UN	1.0000	0.6700	0.3300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.0000	0.1000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	32204	CLORETO DE SODIO 0,9% 10 ML SI IV AP	1.9200	0.0000	1.9200	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	d4089ccef13567fd45b16fb0b60685fa	VERA	12640482546	NULL	12640482546	25040014	ASSISTENCIA FISIATRICA RESPIRATORIA	0.0000	5.0300	NULL	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	818a6f2e549cc6a60aa20f9d0595eec9	ANTONIO	12565134343	NULL	12565134343	19160	SERINGA DESC 20 ML UN	0.5400	0.5374	0.0026	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	818a6f2e549cc6a60aa20f9d0595eec9	ANTONIO	12565134343	NULL	12565134343	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1767	0.0033	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	a050ed50115d2a6dd0b15b99b39063da	ARI	12676101147	NULL	12676101147	19160	SERINGA DESC 20 ML UN	0.5400	0.5367	0.0033	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	a050ed50115d2a6dd0b15b99b39063da	ARI	12676101147	NULL	12676101147	19160	SERINGA DESC 20 ML UN	0.5400	0.5367	0.0033	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	a050ed50115d2a6dd0b15b99b39063da	ARI	12676101147	NULL	12676101147	13404	OMEPRAZOL 40 MG + DIL. 10 ML PO IV FA	19.5800	19.5750	0.0050	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	500e4b8f04552b423f9db8f81073659f	FIDELIS	12669067840	NULL	12669067840	07269	DIPIRONA 500 MG/ML 2 ML SI IV IM AP	0.6900	0.6800	0.0000	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	39df67956a358bf1eab89803158d25dd	HELENA	12655863342	NULL	12655863342	07269	DIPIRONA 500 MG/ML 2 ML SI IV IM AP	0.6900	0.6800	0.0000	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	39df67956a358bf1eab89803158d25dd	HELENA	12655863342	NULL	12655863342	27480	CLARITROMICINA 500 MG 30 ML PO IV FA	117.1100	117.1050	0.0050	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	9d06dbe3a8516628c3a045963dfb9c42	INAN	12623574546	NULL	12623574546	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4000	0.0000	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	9d06dbe3a8516628c3a045963dfb9c42	INAN	12623574546	NULL	12623574546	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1757	0.0043	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	4668d2494ed6c4b2d18be299efcb26a2	JOAO	12469689344	NULL	12469689344	05975	COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER	0.6000	0.3800	0.2200	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	4668d2494ed6c4b2d18be299efcb26a2	JOAO	12469689344	NULL	12469689344	17817	PROLOPA (LEVODOPA 200 MG + BENSERAZIDA 50 M	2.1200	2.1150	0.0050	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	0981c22c3928fe5329caff0f4f9420bd	ZERONICE	12693863740	NULL	12693863740	33219	LUVA DE PROCEDIMENTO UNIDADE UN	0.1700	0.1600	0.0000	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	01081195	09b43710c67be7d131dc36e0a502826c	ERICK	12743745311	NULL	12743745311	00010014	CONSULTA EM CONSULTORIO MEDICO	0.0000	35.0000	NULL	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	01081195	160faa4740fe4679f6fbd15ce9d84e42	GABRIELA	12743771213	NULL	12743771213	00010014	CONSULTA EM CONSULTORIO MEDICO	0.0000	35.0000	NULL	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	01081195	c08eb34e3cdcaf6866e8b44970c2170d	HELENA	12732494910	NULL	12732494910	00010014	CONSULTA EM CONSULTORIO MEDICO	0.0000	35.0000	NULL	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	01081195	307aba86e3ba2f8e22e8cacd260336a4	SOLANGE	12725256015	NULL	12725256015	00010014	CONSULTA EM CONSULTORIO MEDICO	0.0000	50.0000	NULL	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	01081197	09b43710c67be7d131dc36e0a502826c	ERICK	12743755120	NULL	12743755120	20010010	ECG - ELETROCARDIOGRAMA	0.0000	11.5710	NULL	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	01081197	6cc865b10b9b19e72ae4fa1d739f24ec	LAURITA	12743101628	NULL	12743101628	20010010	ECG - ELETROCARDIOGRAMA	0.0000	11.5710	NULL	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	eecb3d883747b059c3fe231c34567476	AFFRIDES	12693180144	NULL	12693180144	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1770	0.0030	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	eecb3d883747b059c3fe231c34567476	AFFRIDES	12693180144	NULL	12693180144	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1770	0.0030	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	eecb3d883747b059c3fe231c34567476	AFFRIDES	12693180144	NULL	12693180144	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1770	0.0030	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	eecb3d883747b059c3fe231c34567476	AFFRIDES	12693180144	NULL	12693180144	00426	AGUA BIDESTILADA 10 ML SI IV IM AP	0.8100	0.8072	0.0028	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	eecb3d883747b059c3fe231c34567476	AFFRIDES	12693180144	NULL	12693180144	00426	AGUA BIDESTILADA 10 ML SI IV IM AP	0.8100	0.8072	0.0028	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	eecb3d883747b059c3fe231c34567476	AFFRIDES	12693180144	NULL	12693180144	00426	AGUA BIDESTILADA 10 ML SI IV IM AP	0.8100	0.8072	0.0028	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	eecb3d883747b059c3fe231c34567476	AFFRIDES	12693180144	NULL	12693180144	09733	ACETILCISTEINA 600MG PO VO SA	3.5000	3.4955	0.0045	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	eecb3d883747b059c3fe231c34567476	AFFRIDES	12693180144	NULL	12693180144	09733	ACETILCISTEINA 600MG PO VO SA	3.5000	3.4955	0.0045	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	eecb3d883747b059c3fe231c34567476	AFFRIDES	12693180144	NULL	12693180144	09733	ACETILCISTEINA 600MG PO VO SA	3.5000	3.4955	0.0045	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	eecb3d883747b059c3fe231c34567476	AFFRIDES	12693180144	NULL	12693180144	09733	ACETILCISTEINA 600MG PO VO SA	3.5000	3.4955	0.0045	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	eecb3d883747b059c3fe231c34567476	AFFRIDES	12693180144	NULL	12693180144	09733	ACETILCISTEINA 600MG PO VO SA	3.5000	3.4955	0.0045	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	08664	ESPARADRAPO MICROPORE 50 X 10 CM CM	0.7700	0.7682	0.0018	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	20672	SORO RINGER SIMPLES 500 ML SI IV BS	5.9400	5.9364	0.0036	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	58661	ENCRISE (ARGIPRESSINA) 20 U/ML 1 ML SI SC	40.2400	40.2343	0.0057	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	22896	CEFUROXIMA 750 MG + DIL. 6 ML PO IM IV FA	26.1300	26.1271	0.0029	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	42358	FUROSEMIDA 10 MG/ML 2 ML SI IM IV AP	0.6000	0.5986	0.0014	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	42358	FUROSEMIDA 10 MG/ML 2 ML SI IM IV AP	0.6000	0.5986	0.0014	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	42358	FUROSEMIDA 10 MG/ML 2 ML SI IM IV AP	0.6000	0.5986	0.0014	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4078	0.0022	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4078	0.0022	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4078	0.0022	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4078	0.0022	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4078	0.0022	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4078	0.0022	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4078	0.0022	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4078	0.0022	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4078	0.0022	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4078	0.0022	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	33227	LUVA CIRURGICA PAR UN	1.4500	1.4476	0.0024	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	33227	LUVA CIRURGICA PAR UN	1.4500	1.4476	0.0024	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	33227	LUVA CIRURGICA PAR UN	1.4500	1.4476	0.0024	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	33227	LUVA CIRURGICA PAR UN	1.4500	1.4476	0.0024	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	33227	LUVA CIRURGICA PAR UN	1.4500	1.4476	0.0024	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.1034	-0.0034	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.1038	-0.0038	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.1038	-0.0038	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	b288bbcfb9aecab51bcb0dba62ca0059	IVONETE	12743730847	NULL	12743730847	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4067	0.0033	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	b288bbcfb9aecab51bcb0dba62ca0059	IVONETE	12743730847	NULL	12743730847	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4067	0.0033	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	b288bbcfb9aecab51bcb0dba62ca0059	IVONETE	12743730847	NULL	12743730847	19160	SERINGA DESC 20 ML UN	0.5400	0.5367	0.0033	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	b288bbcfb9aecab51bcb0dba62ca0059	IVONETE	12743730847	NULL	12743730847	19160	SERINGA DESC 20 ML UN	0.5400	0.5367	0.0033	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1900	0.1900	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1900	0.1900	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	33227	LUVA CIRURGICA PAR UN	1.4500	0.0000	1.4500	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	05975	COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER	0.6000	0.3833	0.2167	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4084	0.0016	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4084	0.0016	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4084	0.0016	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4084	0.0016	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4084	0.0016	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4084	0.0016	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	2a79bf9d53875b480086bd7b8321c4f1	JOSE	12641066643	NULL	12641066643	00035	ABOCATH (CATETER INTRAVENOSO) N. 14 A 22 UN	3.7700	3.7600	0.0000	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	2a79bf9d53875b480086bd7b8321c4f1	JOSE	12641066643	NULL	12641066643	12262	ISOSSORBIDA 20 MG CP VO UN	0.2200	0.2167	0.0033	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1965b0cdebe9017c3397c8641147759	JOSE	12705413746	NULL	12705413746	18457	REPARIL (ESCINA + DIETILAMONIO) GL TP GR	3.7500	0.0000	3.7500	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1965b0cdebe9017c3397c8641147759	JOSE	12705413746	NULL	12705413746	00035	ABOCATH (CATETER INTRAVENOSO) N. 14 A 22 UN	3.7700	3.7700	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1965b0cdebe9017c3397c8641147759	JOSE	12705413746	NULL	12705413746	00035	ABOCATH (CATETER INTRAVENOSO) N. 14 A 22 UN	7.5300	7.5300	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1965b0cdebe9017c3397c8641147759	JOSE	12705413746	NULL	12705413746	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4074	0.0026	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	62aae4e8542779ba735279cbf8749d41	LAENE	12728266347	NULL	12728266347	19160	SERINGA DESC 20 ML UN	0.5400	0.5300	0.0000	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	62aae4e8542779ba735279cbf8749d41	LAENE	12728266347	NULL	12728266347	00426	AGUA BIDESTILADA 10 ML SI IV IM AP	0.8100	0.8000	0.0000	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	20cbe2e07b1dcd2b6af609a50df7ae80	LUCELENA	12690767849	NULL	12690767849	19160	SERINGA DESC 20 ML UN	0.5400	0.5384	0.0016	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	32204	CLORETO DE SODIO 0,9% 10 ML SI IV AP	0.4800	0.0000	0.4800	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	32204	CLORETO DE SODIO 0,9% 10 ML SI IV AP	0.4800	0.4800	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	00426	AGUA BIDESTILADA 10 ML SI IV IM AP	0.8100	0.8067	0.0033	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	00426	AGUA BIDESTILADA 10 ML SI IV IM AP	0.8100	0.8067	0.0033	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	32204	CLORETO DE SODIO 0,9% 10 ML SI IV AP	0.4800	0.0000	0.4800	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	32204	CLORETO DE SODIO 0,9% 10 ML SI IV AP	0.9600	0.9600	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	05975	COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER	0.3000	0.0000	0.3000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	37761	ALCOOL ETILICO 70 % ST TP ML	0.0300	0.0000	0.0300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	37761	ALCOOL ETILICO 70 % ST TP ML	0.0300	0.0200	0.0100	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	32204	CLORETO DE SODIO 0,9% 10 ML SI IV AP	0.4800	0.0000	0.4800	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00426	AGUA BIDESTILADA 10 ML SI IV IM AP	0.4000	0.0000	0.4000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00426	AGUA BIDESTILADA 10 ML SI IV IM AP	0.8100	0.8080	0.0020	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	08648	ESPARADRAPO 10 X 4.5 CM CM	0.4000	0.2000	0.2000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	32204	CLORETO DE SODIO 0,9% 10 ML SI IV AP	0.4800	0.0000	0.4800	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	32204	CLORETO DE SODIO 0,9% 10 ML SI IV AP	0.4800	0.0000	0.4800	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	14460	DOMPERIDONA 10 MG CP VO UN	0.3900	0.0000	0.3900	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	e715e2ae28a6229c8609756d3298bf52	MARIA	12734221144	NULL	12734221144	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1750	0.0050	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	e715e2ae28a6229c8609756d3298bf52	MARIA	12734221144	NULL	12734221144	30511	CEFALOTINA 1 G FA + DIL. 10 ML FA	4.6600	4.6550	0.0050	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	e715e2ae28a6229c8609756d3298bf52	MARIA	12734221144	NULL	12734221144	30511	CEFALOTINA 1 G FA + DIL. 10 ML FA	4.6600	4.6550	0.0050	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	11193	CLOREXIDINA 2 % ST TP ML	0.1300	0.0000	0.1300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	11193	CLOREXIDINA 2 % ST TP ML	0.2700	0.0000	0.2700	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	05975	COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER	0.3000	0.3836	-0.0836	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	33537	PIPERACILINA 2 G + TAZOBACTAM 250 MG 30 ML	55.3400	55.3375	0.0025	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	33537	PIPERACILINA 2 G + TAZOBACTAM 250 MG 30 ML	55.3400	55.3375	0.0025	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	42358	FUROSEMIDA 10 MG/ML 2 ML SI IM IV AP	1.2000	1.1964	0.0036	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4061	0.0039	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4061	0.0039	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4061	0.0039	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	33227	LUVA CIRURGICA PAR UN	1.4500	2.8964	-1.4464	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	33227	LUVA CIRURGICA PAR UN	1.4500	1.4477	0.0023	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	33227	LUVA CIRURGICA PAR UN	1.4500	1.4477	0.0023	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	33227	LUVA CIRURGICA PAR UN	1.4500	1.4477	0.0023	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	33227	LUVA CIRURGICA PAR UN	1.4500	1.4477	0.0023	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	33227	LUVA CIRURGICA PAR UN	1.4500	1.4477	0.0023	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	33227	LUVA CIRURGICA PAR UN	1.4500	1.4477	0.0023	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	33227	LUVA CIRURGICA PAR UN	1.4500	1.4477	0.0023	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	19135	SERINGA DESC 03 ML UN	0.3000	0.0000	0.3000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	19135	SERINGA DESC 03 ML UN	0.1500	0.0000	0.1500	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	19135	SERINGA DESC 03 ML UN	0.3000	0.0000	0.3000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00817	ALGODAO HIDROFILO BOLINHA UN	0.2600	0.1300	0.1300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	19135	SERINGA DESC 03 ML UN	0.1500	0.0000	0.1500	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	19135	SERINGA DESC 03 ML UN	0.1500	0.1500	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	19151	SERINGA DESC 10 ML UN	0.6700	0.6657	0.0043	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	19151	SERINGA DESC 10 ML UN	0.6700	0.6657	0.0043	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	19151	SERINGA DESC 10 ML UN	0.6700	0.6657	0.0043	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.2100	0.2057	0.0043	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1772	0.0028	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1772	0.0028	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1772	0.0028	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	08664	ESPARADRAPO MICROPORE 50 X 10 CM CM	0.7700	0.7670	0.0030	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	cd2840524be5a3f1d0939f241e24f32b	MARIA	12705908340	NULL	12705908340	32204	CLORETO DE SODIO 0,9% 10 ML SI IV AP	0.4800	0.4800	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	cd2840524be5a3f1d0939f241e24f32b	MARIA	12705908340	NULL	12705908340	32204	CLORETO DE SODIO 0,9% 10 ML SI IV AP	0.4800	0.4800	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	cd2840524be5a3f1d0939f241e24f32b	MARIA	12705908340	NULL	12705908340	33219	LUVA DE PROCEDIMENTO UNIDADE UN	1.0000	0.6700	0.3300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	cd2840524be5a3f1d0939f241e24f32b	MARIA	12705908340	NULL	12705908340	32204	CLORETO DE SODIO 0,9% 10 ML SI IV AP	0.4800	0.4800	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	cd2840524be5a3f1d0939f241e24f32b	MARIA	12705908340	NULL	12705908340	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1764	0.0036	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	d17b3c5ae418d82694895a326dee545a	ODILIA	12670516743	NULL	12670516743	00817	ALGODAO HIDROFILO BOLINHA UN	0.1300	0.0000	0.1300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	d17b3c5ae418d82694895a326dee545a	ODILIA	12670516743	NULL	12670516743	00817	ALGODAO HIDROFILO BOLINHA UN	0.1300	0.1300	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	d17b3c5ae418d82694895a326dee545a	ODILIA	12670516743	NULL	12670516743	30376	BROMETO DE IPRATROPIO 0,25MG/ML SL IN GT	0.4000	0.0000	0.4000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	d17b3c5ae418d82694895a326dee545a	ODILIA	12670516743	NULL	12670516743	00817	ALGODAO HIDROFILO BOLINHA UN	0.1300	0.0000	0.1300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1766	0.0034	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1766	0.0034	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	8a5ecfde671848d05ac757e0112e689c	TEREZINHA	12700337042	NULL	12700337042	10626	GLICOSE 50% 10 ML SI IV AP	2.7400	2.7350	0.0050	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	8a5ecfde671848d05ac757e0112e689c	TEREZINHA	12700337042	NULL	12700337042	57258	FUMARATO DE QUETIAPINA 25 MG CA VO UN	1.2500	1.2450	0.0050	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	8a5ecfde671848d05ac757e0112e689c	TEREZINHA	12700337042	NULL	12700337042	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4071	0.0029	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	8a5ecfde671848d05ac757e0112e689c	TEREZINHA	12700337042	NULL	12700337042	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4071	0.0029	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	8a5ecfde671848d05ac757e0112e689c	TEREZINHA	12700337042	NULL	12700337042	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4071	0.0029	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	8a5ecfde671848d05ac757e0112e689c	TEREZINHA	12700337042	NULL	12700337042	19160	SERINGA DESC 20 ML UN	0.5400	0.5376	0.0024	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	8a5ecfde671848d05ac757e0112e689c	TEREZINHA	12700337042	NULL	12700337042	19160	SERINGA DESC 20 ML UN	0.5400	0.5376	0.0024	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	8a5ecfde671848d05ac757e0112e689c	TEREZINHA	12700337042	NULL	12700337042	19160	SERINGA DESC 20 ML UN	0.5400	0.5376	0.0024	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	8a5ecfde671848d05ac757e0112e689c	TEREZINHA	12700337042	NULL	12700337042	19160	SERINGA DESC 20 ML UN	0.5400	0.5376	0.0024	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	70cf23c63f890f0b61da2542c3e13a09	TIAGO	12741864645	NULL	12741864645	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1762	0.0038	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	70cf23c63f890f0b61da2542c3e13a09	TIAGO	12741864645	NULL	12741864645	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4075	0.0025	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	05975	COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER	0.0600	0.0000	0.0600	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	05975	COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER	0.3000	0.0000	0.3000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	33227	LUVA CIRURGICA PAR UN	1.4500	1.4476	0.0024	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	0111beed375944f60c7ad4a7fd4874f8	WALDIR	12746025744	NULL	12746025744	00426	AGUA BIDESTILADA 10 ML SI IV IM AP	1.6200	1.6147	0.0053	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	0111beed375944f60c7ad4a7fd4874f8	WALDIR	12746025744	NULL	12746025744	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4076	0.0024	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	0111beed375944f60c7ad4a7fd4874f8	WALDIR	12746025744	NULL	12746025744	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4076	0.0024	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	0111beed375944f60c7ad4a7fd4874f8	WALDIR	12746025744	NULL	12746025744	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4076	0.0024	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	0111beed375944f60c7ad4a7fd4874f8	WALDIR	12746025744	NULL	12746025744	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4076	0.0024	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	0111beed375944f60c7ad4a7fd4874f8	WALDIR	12746025744	NULL	12746025744	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4076	0.0024	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	0111beed375944f60c7ad4a7fd4874f8	WALDIR	12746025744	NULL	12746025744	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4076	0.0024	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	0111beed375944f60c7ad4a7fd4874f8	WALDIR	12746025744	NULL	12746025744	19160	SERINGA DESC 20 ML UN	0.5400	0.5379	0.0021	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	0111beed375944f60c7ad4a7fd4874f8	WALDIR	12746025744	NULL	12746025744	19160	SERINGA DESC 20 ML UN	0.5400	0.5379	0.0021	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	0111beed375944f60c7ad4a7fd4874f8	WALDIR	12746025744	NULL	12746025744	19160	SERINGA DESC 20 ML UN	0.5400	0.5379	0.0021	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	37761	ALCOOL ETILICO 70 % ST TP ML	0.0600	0.0000	0.0600	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	37761	ALCOOL ETILICO 70 % ST TP ML	0.0600	0.0000	0.0600	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	00817	ALGODAO HIDROFILO BOLINHA UN	0.5100	0.2600	0.2500	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	00817	ALGODAO HIDROFILO BOLINHA UN	0.2600	0.0000	0.2600	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	00817	ALGODAO HIDROFILO BOLINHA UN	0.1300	0.0000	0.1300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	27596	TIRA TESTE PARA GLICOSE UN	1.0400	1.0400	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	27596	TIRA TESTE PARA GLICOSE UN	1.0400	1.0400	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	27596	TIRA TESTE PARA GLICOSE UN	1.0400	1.0400	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	27596	TIRA TESTE PARA GLICOSE UN	1.0400	1.0400	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	27596	TIRA TESTE PARA GLICOSE UN	1.0400	1.0400	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	05975	COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER	0.3000	0.0000	0.3000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12647284040	NULL	12647284040	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4086	0.0014	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12662414945	NULL	12662414945	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4071	0.0029	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12662414945	NULL	12662414945	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4071	0.0029	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12662414945	NULL	12662414945	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4071	0.0029	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12662414945	NULL	12662414945	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4071	0.0029	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12662414945	NULL	12662414945	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4071	0.0029	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12579183644	NULL	12579183644	05975	COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER	0.3000	0.0000	0.3000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12579183644	NULL	12579183644	05975	COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER	0.3000	0.0000	0.3000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12579183644	NULL	12579183644	05975	COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER	0.3000	0.3000	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12579183644	NULL	12579183644	05975	COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER	0.6000	0.6000	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12579183644	NULL	12579183644	05975	COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER	0.3000	0.3000	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12579183644	NULL	12579183644	05975	COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER	0.3000	0.3000	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12579183644	NULL	12579183644	33227	LUVA CIRURGICA PAR UN	1.4500	1.4476	0.0024	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12579183644	NULL	12579183644	33227	LUVA CIRURGICA PAR UN	1.4500	1.4476	0.0024	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12579183644	NULL	12579183644	33227	LUVA CIRURGICA PAR UN	1.4500	1.4476	0.0024	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12579183644	NULL	12579183644	33227	LUVA CIRURGICA PAR UN	1.4500	1.4476	0.0024	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12579183644	NULL	12579183644	33227	LUVA CIRURGICA PAR UN	1.4500	1.4476	0.0024	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12579183644	NULL	12579183644	33227	LUVA CIRURGICA PAR UN	1.4500	1.4476	0.0024	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	08435	EQUIPO P/ BOMBA DE INFUSAO ENTERAL / PARENT	20.2800	0.0000	20.2800	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1770	0.0030	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1770	0.0030	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	11700	EQUIPO P/ BOMBA DE INFUSAO ENTERAL / PARENTERAL	NULL	0.0000	NULL	OPME INVALIDO	2201
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	NULL	0.0000	NULL	OPME INVALIDO	2201
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	52941	Clorexidina Degermante 2% Fr30ml - Solução De Uso Tópico	NULL	0.0000	NULL	OPME INVALIDO	2201
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	34789	SONDA ASPIRAÇAO C/ VALVULA - TODAS - UTI UN	0.9400	0.9367	0.0033	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	18457	REPARIL (ESCINA + DIETILAMONIO) GL TP GR	15.0100	7.5000	7.5100	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	25798	LOSARTANA 50 MG CP VO UN	1.3300	0.0000	1.3300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	34827	TIORFAN (RACECADOTRILA) 100 MG CA VO UN	3.2000	0.0000	3.2000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	32204	CLORETO DE SODIO 0,9% 10 ML SI IV AP	0.4800	0.0000	0.4800	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.2120	-0.1120	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.2120	-0.1120	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.2120	-0.1120	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.2120	-0.1120	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.2120	-0.1120	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.1060	-0.0060	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.1060	-0.0060	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.1060	-0.0060	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.1060	-0.0060	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.1060	-0.0060	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.1060	-0.0060	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.1060	-0.0060	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.1060	-0.0060	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.1060	-0.0060	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	34827	TIORFAN (RACECADOTRILA) 100 MG CA VO UN	3.2000	6.4000	-3.2000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	34827	TIORFAN (RACECADOTRILA) 100 MG CA VO UN	3.2000	3.2000	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	27596	TIRA TESTE PARA GLICOSE UN	1.0400	1.0400	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	19160	SERINGA DESC 20 ML UN	0.5400	0.5374	0.0026	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	19445	CLORETO DE POTASSIO 600 MG CA VO UN	1.4637	1.9474	-1.4574	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	07587	DRAMIN B6 DL (DIMENIDRINATO + PIRIDOXINA +	13.2771	15.4941	-13.2841	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	31585	RANITIDINA 25 MG/ML 2 ML SI IV IM AP	0.9300	1.8668	-0.9368	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	31585	RANITIDINA 25 MG/ML 2 ML SI IV IM AP	0.9300	0.9334	-0.0034	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	31585	RANITIDINA 25 MG/ML 2 ML SI IV IM AP	0.9300	0.9334	-0.0034	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	31585	RANITIDINA 25 MG/ML 2 ML SI IV IM AP	0.9300	0.9334	-0.0034	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	19151	SERINGA DESC 10 ML UN	0.6634	1.0003	-0.6703	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	19151	SERINGA DESC 10 ML UN	0.6634	1.0003	-0.6703	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	19151	SERINGA DESC 10 ML UN	0.6634	1.0003	-0.6703	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	19151	SERINGA DESC 10 ML UN	0.3300	0.6669	-0.3369	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	19151	SERINGA DESC 10 ML UN	0.3300	0.6669	-0.3369	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	19151	SERINGA DESC 10 ML UN	0.3300	0.6669	-0.3369	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	19151	SERINGA DESC 10 ML UN	0.3300	0.6669	-0.3369	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	13935	METAMUCIL (PLANTAGO OVATA) 5,85 G PO VO E	4.9236	7.3908	-4.9308	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	07269	DIPIRONA 500 MG/ML 2 ML SI IV IM AP	0.6900	0.6860	0.0040	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	37761	ALCOOL ETILICO 70 % ST TP ML	0.0631	0.0696	-0.0396	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	37761	ALCOOL ETILICO 70 % ST TP ML	0.0631	0.0695	-0.0395	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	53660	EQUIPO MACRO-GOTAS FLEXIVEL C/ INJETOR LATE	1.5900	1.5900	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	21822	TRAMADOL 50 MG 1 ML SI IM IV AP	25.1571	29.3540	-25.1640	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	11193	CLOREXIDINA 2 % ST TP ML	0.5300	0.5320	-0.0020	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	11193	CLOREXIDINA 2 % ST TP ML	0.5300	0.5320	-0.0020	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	800720d33fe0defb6121e82dd216d044	JALMO	12786952647	NULL	12786952647	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	800720d33fe0defb6121e82dd216d044	JALMO	12786952647	NULL	12786952647	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	800720d33fe0defb6121e82dd216d044	JALMO	12786952647	NULL	12786952647	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	11700	EQUIPO P/ BOMBA DE INFUSAO ENTERAL / PARENTERAL	0.0000	20.2800	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4075	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	01611	CLORETO DE POTASSIO 600 MG CA VO UN	0.0000	0.0000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00172	SORO FISIOLOGICO 0,9% 500 ML SI IV BS	0.0000	4.7300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00172	SORO FISIOLOGICO 0,9% 500 ML SI IV BS	0.0000	4.7300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	02246	HIDROCORTISONA 100 MG PO IM IV FA	0.0000	2.8300	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	02246	HIDROCORTISONA 100 MG PO IM IV FA	0.0000	2.8300	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	02246	HIDROCORTISONA 100 MG PO IM IV FA	0.0000	2.8300	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	02246	HIDROCORTISONA 100 MG PO IM IV FA	0.0000	2.8300	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	02246	HIDROCORTISONA 100 MG PO IM IV FA	0.0000	2.8300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	02246	HIDROCORTISONA 100 MG PO IM IV FA	0.0000	5.6700	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	02246	HIDROCORTISONA 100 MG PO IM IV FA	0.0000	5.6700	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	26981	SORO FISIOLOGICO 0,9% 10 ML SI IV AP	0.0000	0.0000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	26981	SORO FISIOLOGICO 0,9% 10 ML SI IV AP	0.0000	0.0000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	26981	SORO FISIOLOGICO 0,9% 10 ML SI IV AP	0.0000	0.4800	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	26981	SORO FISIOLOGICO 0,9% 10 ML SI IV AP	0.0000	0.9600	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	26981	SORO FISIOLOGICO 0,9% 10 ML SI IV AP	0.0000	0.9600	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	29020166	Nebulização Simples com Broncodilatador	0.0000	53.8600	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00613	CLINDAMICINA 600 MG 4 ML SI IM IV AP	0.0000	13.0800	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00613	CLINDAMICINA 600 MG 4 ML SI IM IV AP	0.0000	13.0800	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00613	CLINDAMICINA 600 MG 4 ML SI IM IV AP	0.0000	13.0800	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00613	CLINDAMICINA 600 MG 4 ML SI IM IV AP	0.0000	13.0800	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00069	SERINGA DESC 10 ML UN	0.0000	0.0000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00796	FLORATIL (SACCHAROMYCES BOULARDII) 200 MG PO VO	0.0000	4.4400	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	08829	Bricanyl 0,5mg Inj. Ampola C/ 1ml	0.0000	3.5900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	09071	ACETILCISTEINA 600MG PO VO SA	0.0000	3.4950	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	09071	ACETILCISTEINA 600MG PO VO SA	0.0000	3.4950	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	09071	ACETILCISTEINA 600MG PO VO SA	0.0000	3.4950	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	09071	ACETILCISTEINA 600MG PO VO SA	0.0000	3.4950	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	09071	ACETILCISTEINA 600MG PO VO SA	0.0000	3.4950	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00091	SERINGA DESC 01 ML (INSULINA) UN	0.0000	0.3057	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00124	LUVA CIRURGICA UN	0.0000	1.4475	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00124	LUVA CIRURGICA UN	0.0000	1.4475	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4062	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4062	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4062	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4062	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	6.8124	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	01584	NEOSTIGMINA 0,5 MG/ML 1 ML SI IM IV SC AP	0.0000	0.7656	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	01584	NEOSTIGMINA 0,5 MG/ML 1 ML SI IM IV SC AP	0.0000	0.7667	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	01584	NEOSTIGMINA 0,5 MG/ML 1 ML SI IM IV SC AP	0.0000	0.7667	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	01584	NEOSTIGMINA 0,5 MG/ML 1 ML SI IM IV SC AP	0.0000	0.7667	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00170	SORO GLICOSADO 5% 250 ML SI IV BS	0.0000	3.4000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	24082	BROMOPRIDA 5 MG/ML 2 ML SI IM IV AP	0.0000	2.7300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	24082	BROMOPRIDA 5 MG/ML 2 ML SI IM IV AP	0.0000	2.7300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	24082	BROMOPRIDA 5 MG/ML 2 ML SI IM IV AP	0.0000	2.7300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	24082	BROMOPRIDA 5 MG/ML 2 ML SI IM IV AP	0.0000	2.7300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	24082	BROMOPRIDA 5 MG/ML 2 ML SI IM IV AP	0.0000	2.7300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00796	FLORATIL (SACCHAROMYCES BOULARDII) 200 MG PO VO	0.0000	4.4400	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00796	FLORATIL (SACCHAROMYCES BOULARDII) 200 MG PO VO	0.0000	4.4400	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00090	SERINGA DESC 20 ML UN	0.0000	0.5332	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00090	SERINGA DESC 20 ML UN	0.0000	0.5371	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00090	SERINGA DESC 20 ML UN	0.0000	0.5371	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00090	SERINGA DESC 20 ML UN	0.0000	0.5371	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00090	SERINGA DESC 20 ML UN	0.0000	0.5371	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00090	SERINGA DESC 20 ML UN	0.0000	0.5371	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00090	SERINGA DESC 20 ML UN	0.0000	0.5371	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00090	SERINGA DESC 20 ML UN	0.0000	0.5371	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00090	SERINGA DESC 20 ML UN	0.0000	0.5371	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00090	SERINGA DESC 20 ML UN	0.0000	0.5371	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00090	SERINGA DESC 20 ML UN	0.0000	0.5371	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00090	SERINGA DESC 20 ML UN	0.0000	0.5371	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00090	SERINGA DESC 20 ML UN	0.0000	0.5371	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00090	SERINGA DESC 20 ML UN	0.0000	0.5371	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00090	SERINGA DESC 20 ML UN	0.0000	0.5371	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00090	SERINGA DESC 20 ML UN	0.0000	0.5371	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00090	SERINGA DESC 20 ML UN	0.0000	0.5371	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00943	EQUIPO POLIFIX 2 VIAS UN	0.0000	2.5500	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00943	EQUIPO POLIFIX 2 VIAS UN	0.0000	2.5500	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4088	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4088	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1766	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1766	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1766	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1766	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00735	CEFTRIAXONA IV 1G + DIL. 10 ML PO IV FA	0.0000	0.0000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00090	SERINGA DESC 20 ML UN	0.0000	0.5387	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00090	SERINGA DESC 20 ML UN	0.0000	0.5387	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00090	SERINGA DESC 20 ML UN	0.0000	0.5387	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00090	SERINGA DESC 20 ML UN	0.0000	0.5387	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00090	SERINGA DESC 20 ML UN	0.0000	0.5387	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00090	SERINGA DESC 20 ML UN	0.0000	0.5387	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00090	SERINGA DESC 20 ML UN	0.0000	0.5387	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00090	SERINGA DESC 20 ML UN	0.0000	0.5387	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4070	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4070	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12550571048	NULL	12550571048	00124	LUVA CIRURGICA UN	0.0000	1.4473	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12550571048	NULL	12550571048	00124	LUVA CIRURGICA UN	0.0000	1.4500	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12550571048	NULL	12550571048	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4074	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12550571048	NULL	12550571048	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4074	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12550571048	NULL	12550571048	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4074	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12550571048	NULL	12550571048	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4074	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12550571048	NULL	12550571048	25040014	Fisioterapia Respiratória - em Doente Clínico Internado	0.0000	10.0600	NULL	EXAME NAO AUTORIZADO	2707
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12550571048	NULL	12550571048	29020166	Nebulização Simples com Broncodilatador	0.0000	7.0200	NULL	EXAME NAO AUTORIZADO	2707
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12550571048	NULL	12550571048	00487	RANITIDINA 25 MG/ML 2 ML SI IM IV AP	0.0000	0.9300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12550571048	NULL	12550571048	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.0000	0.8073	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12550571048	NULL	12550571048	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.0000	0.8073	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12550571048	NULL	12550571048	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.0000	0.8073	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12550571048	NULL	12550571048	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1775	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12550571048	NULL	12550571048	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1775	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12550571048	NULL	12550571048	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1775	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12550571048	NULL	12550571048	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1800	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12550571048	NULL	12550571048	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1775	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12550571048	NULL	12550571048	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1775	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12550571048	NULL	12550571048	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1775	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	9ffbbf7340bbd65e9e3baa9406d027f3	MARCO	12261811645	NULL	12261811645	00090	SERINGA DESC 20 ML UN	0.0000	0.5376	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	9ffbbf7340bbd65e9e3baa9406d027f3	MARCO	12261811645	NULL	12261811645	00090	SERINGA DESC 20 ML UN	0.0000	0.5376	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	9ffbbf7340bbd65e9e3baa9406d027f3	MARCO	12261811645	NULL	12261811645	00090	SERINGA DESC 20 ML UN	0.0000	0.5376	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12579183644	NULL	12579183644	00124	LUVA CIRURGICA UN	0.0000	1.4476	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12579183644	NULL	12579183644	25040014	Fisioterapia Respiratória - em Doente Clínico Internado	0.0000	10.0600	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12579183644	NULL	12579183644	25040014	Fisioterapia Respiratória - em Doente Clínico Internado	0.0000	10.0600	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12579183644	NULL	12579183644	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12579183644	NULL	12579183644	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12579183644	NULL	12579183644	35382	COMPRESSAS DE GASES 7.5 X7,5 (11 FIOS ESTERIL) UN	0.0000	0.3000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12579183644	NULL	12579183644	35382	COMPRESSAS DE GASES 7.5 X7,5 (11 FIOS ESTERIL) UN	0.0000	0.1667	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12579183644	NULL	12579183644	35382	COMPRESSAS DE GASES 7.5 X7,5 (11 FIOS ESTERIL) UN	0.0000	0.3000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12579183644	NULL	12579183644	35382	COMPRESSAS DE GASES 7.5 X7,5 (11 FIOS ESTERIL) UN	0.0000	0.3000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12579183644	NULL	12579183644	51584	ESPARADRAPO MICROPORE	0.0000	0.2600	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12579183644	NULL	12579183644	51584	ESPARADRAPO MICROPORE	0.0000	0.2600	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12579183644	NULL	12579183644	00090	SERINGA DESC 20 ML UN	0.0000	0.5366	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	00124	LUVA CIRURGICA UN	0.0000	1.4482	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	00124	LUVA CIRURGICA UN	0.0000	1.4500	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	00124	LUVA CIRURGICA UN	0.0000	1.4482	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	00128	LUVA DE PROCEDIMENTO UNIDADE UN	0.0000	1.6700	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4098	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.0000	0.6800	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	35382	COMPRESSAS DE GASES 7.5 X7,5 (11 FIOS ESTERIL) UN	0.0000	0.0600	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.0000	0.4000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.0000	0.4000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.0000	0.4000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1752	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1752	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1752	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	51241	AGULHA 123X45	0.0000	0.1900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	51241	AGULHA 123X45	0.0000	0.1900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	51241	AGULHA 123X45	0.0000	0.1900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	51649	ALCOOL ETILICO 70 % ST TP ML	0.0000	0.0300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	52392	SONDA DE ASPIRAÇAO TRAQUEAL C/ VALVULA UN	0.0000	0.9352	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	52392	SONDA DE ASPIRAÇAO TRAQUEAL C/ VALVULA UN	0.0000	0.9336	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	52392	SONDA DE ASPIRAÇAO TRAQUEAL C/ VALVULA UN	0.0000	0.9352	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	52392	SONDA DE ASPIRAÇAO TRAQUEAL C/ VALVULA UN	0.0000	0.9352	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	52392	SONDA DE ASPIRAÇAO TRAQUEAL C/ VALVULA UN	0.0000	0.9400	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	52392	SONDA DE ASPIRAÇAO TRAQUEAL C/ VALVULA UN	0.0000	0.9400	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.0000	0.6874	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.0000	0.6874	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.3500	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	53945	ACIDO ASCORBICO 500 MG CP VO UN	0.0000	0.5900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00125	LUVA CIRURGICA UN	0.0000	1.4500	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00128	LUVA DE PROCEDIMENTO UNIDADE UN	0.0000	1.6700	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	24082	BROMOPRIDA 5 MG/ML 2 ML SI IM IV AP	0.0000	2.7300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	24082	BROMOPRIDA 5 MG/ML 2 ML SI IM IV AP	0.0000	2.7300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	24082	BROMOPRIDA 5 MG/ML 2 ML SI IM IV AP	0.0000	2.7300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	ea4ad2636c25d8e3dbb569ae62db71e7	IONE	12489788840	NULL	12489788840	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.0000	0.4000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	ea4ad2636c25d8e3dbb569ae62db71e7	IONE	12489788840	NULL	12489788840	00737	CEFTRIAXONA IV 1G + DIL. 10 ML PO IV FA	0.0000	27.0600	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	d17b3c5ae418d82694895a326dee545a	ODILIA	12670516743	NULL	12670516743	00128	LUVA DE PROCEDIMENTO UNIDADE UN	0.0000	1.6700	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	d17b3c5ae418d82694895a326dee545a	ODILIA	12670516743	NULL	12670516743	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	OPME INVALIDO	2201
Glosa Min	2018-10-03 00:00:00.000000	1084117	d17b3c5ae418d82694895a326dee545a	ODILIA	12670516743	NULL	12670516743	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	d17b3c5ae418d82694895a326dee545a	ODILIA	12670516743	NULL	12670516743	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	d17b3c5ae418d82694895a326dee545a	ODILIA	12670516743	NULL	12670516743	02197	METAMUCIL (PLANTAGO OVATA) 3,4 G PO VO EV	0.0000	2.4600	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	d17b3c5ae418d82694895a326dee545a	ODILIA	12670516743	NULL	12670516743	02197	METAMUCIL (PLANTAGO OVATA) 3,4 G PO VO EV	0.0000	2.4600	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	d17b3c5ae418d82694895a326dee545a	ODILIA	12670516743	NULL	12670516743	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	d17b3c5ae418d82694895a326dee545a	ODILIA	12670516743	NULL	12670516743	00404	LACTULOSE 667 MG/ML XP VO ML	0.0000	6.4300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	d17b3c5ae418d82694895a326dee545a	ODILIA	12670516743	NULL	12670516743	51208	SORO RINGER SIMPLES 500 ML SI IV BS	0.0000	5.9400	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1965b0cdebe9017c3397c8641147759	JOSE	12705413746	NULL	12705413746	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4074	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1965b0cdebe9017c3397c8641147759	JOSE	12705413746	NULL	12705413746	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4074	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1965b0cdebe9017c3397c8641147759	JOSE	12705413746	NULL	12705413746	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4074	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1965b0cdebe9017c3397c8641147759	JOSE	12705413746	NULL	12705413746	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4074	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1965b0cdebe9017c3397c8641147759	JOSE	12705413746	NULL	12705413746	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4074	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1965b0cdebe9017c3397c8641147759	JOSE	12705413746	NULL	12705413746	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4074	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1965b0cdebe9017c3397c8641147759	JOSE	12705413746	NULL	12705413746	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4074	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4072	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	01611	CLORETO DE POTASSIO 600 MG CA VO UN	0.0000	0.4867	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	02246	HIDROCORTISONA 100 MG PO IM IV FA	0.0000	2.8300	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	02246	HIDROCORTISONA 100 MG PO IM IV FA	0.0000	2.8300	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	02246	HIDROCORTISONA 100 MG PO IM IV FA	0.0000	2.8300	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	00404	LACTULOSE 667 MG/ML XP VO ML	0.0000	0.0000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	00404	LACTULOSE 667 MG/ML XP VO ML	0.0000	6.4300	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	00404	LACTULOSE 667 MG/ML XP VO ML	0.0000	6.4300	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.0000	0.4000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1771	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1771	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1771	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1771	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1771	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1771	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1771	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	081fdadb830fb547e83c43fabdb88372	ELZA	12377335349	NULL	12377335349	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1800	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	081fdadb830fb547e83c43fabdb88372	ELZA	12377335349	NULL	12377335349	51240	FITA ADVANTAGE P/ GLICOSE UN	0.0000	2.5900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	081fdadb830fb547e83c43fabdb88372	ELZA	12377335349	NULL	12377335349	09071	ACETILCISTEINA 600MG PO VO SA	0.0000	3.5000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	081fdadb830fb547e83c43fabdb88372	ELZA	12377335349	NULL	12377335349	09071	ACETILCISTEINA 600MG PO VO SA	0.0000	3.5000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	081fdadb830fb547e83c43fabdb88372	ELZA	12377335349	NULL	12377335349	09071	ACETILCISTEINA 600MG PO VO SA	0.0000	3.5000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	24571	CLINDAMICINA 600 MG 4 ML SI IM IV AP	0.0000	13.0800	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	24571	CLINDAMICINA 600 MG 4 ML SI IM IV AP	0.0000	13.0800	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	24571	CLINDAMICINA 600 MG 4 ML SI IM IV AP	0.0000	13.0800	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	24571	CLINDAMICINA 600 MG 4 ML SI IM IV AP	0.0000	13.0800	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	24571	CLINDAMICINA 600 MG 4 ML SI IM IV AP	0.0000	13.0800	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	24571	CLINDAMICINA 600 MG 4 ML SI IM IV AP	0.0000	13.0800	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	24571	CLINDAMICINA 600 MG 4 ML SI IM IV AP	0.0000	13.0800	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	dd486d36a88cfef0b44fe652638a0164	DELFINA	12660326244	NULL	12660326244	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	dd486d36a88cfef0b44fe652638a0164	DELFINA	12660326244	NULL	12660326244	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	dd486d36a88cfef0b44fe652638a0164	DELFINA	12660326244	NULL	12660326244	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	dd486d36a88cfef0b44fe652638a0164	DELFINA	12660326244	NULL	12660326244	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR APRESENTADO A MAIOR	1705
Glosa Min	2018-10-03 00:00:00.000000	1084117	dd486d36a88cfef0b44fe652638a0164	DELFINA	12660326244	NULL	12660326244	14191	OMEPRAZOL 20 MG CA VO UN	0.0000	0.9000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	dd486d36a88cfef0b44fe652638a0164	DELFINA	12660326244	NULL	12660326244	03280	CLOREXIDINA 2 % ST TP ML	0.0000	0.5300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	dd486d36a88cfef0b44fe652638a0164	DELFINA	12660326244	NULL	12660326244	03280	CLOREXIDINA 2 % ST TP ML	0.0000	0.8000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	dd486d36a88cfef0b44fe652638a0164	DELFINA	12660326244	NULL	12660326244	35382	COMPRESSAS DE GASES 7.5 X7,5 (11 FIOS ESTERIL) UN	0.0000	0.6000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	dd486d36a88cfef0b44fe652638a0164	DELFINA	12660326244	NULL	12660326244	00406	FUROSEMIDA 10 MG/ML 2 ML SI IM IV AP	0.0000	0.6000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	dd486d36a88cfef0b44fe652638a0164	DELFINA	12660326244	NULL	12660326244	00487	RANITIDINA 25 MG/ML 2 ML SI IM IV AP	0.0000	0.9300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	dd486d36a88cfef0b44fe652638a0164	DELFINA	12660326244	NULL	12660326244	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.0000	0.4000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	dd486d36a88cfef0b44fe652638a0164	DELFINA	12660326244	NULL	12660326244	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.0000	0.8100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	dd486d36a88cfef0b44fe652638a0164	DELFINA	12660326244	NULL	12660326244	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1800	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	dd486d36a88cfef0b44fe652638a0164	DELFINA	12660326244	NULL	12660326244	51379	SERINGA DESC 05 ML UN	0.0000	0.1900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	dd486d36a88cfef0b44fe652638a0164	DELFINA	12660326244	NULL	12660326244	51379	SERINGA DESC 05 ML UN	0.0000	0.1900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	dd486d36a88cfef0b44fe652638a0164	DELFINA	12660326244	NULL	12660326244	51588	ESPARADRAPO MICROPORE 50 X 10 CM CM	0.0000	0.7700	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	dd486d36a88cfef0b44fe652638a0164	DELFINA	12660326244	NULL	12660326244	51671	REPARIL (ESCINA + DIETILAMONIO) GL TP GR	0.0000	1.8800	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	dd486d36a88cfef0b44fe652638a0164	DELFINA	12660326244	NULL	12660326244	00541	AMIODARONA 200 MG CP VO UN	0.0000	0.8400	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	dd486d36a88cfef0b44fe652638a0164	DELFINA	12660326244	NULL	12660326244	06400	CARVEDILOL 3,125 MG CP VO UN	0.0000	0.7300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	dd486d36a88cfef0b44fe652638a0164	DELFINA	12660326244	NULL	12660326244	06400	CARVEDILOL 3,125 MG CP VO UN	0.0000	0.7300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	dd486d36a88cfef0b44fe652638a0164	DELFINA	12660326244	NULL	12660326244	06400	CARVEDILOL 3,125 MG CP VO UN	0.0000	0.7300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	dd486d36a88cfef0b44fe652638a0164	DELFINA	12660326244	NULL	12660326244	06400	CARVEDILOL 3,125 MG CP VO UN	0.0000	0.7300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	dd486d36a88cfef0b44fe652638a0164	DELFINA	12660326244	NULL	12660326244	06400	CARVEDILOL 3,125 MG CP VO UN	0.0000	0.7300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	102001	DIARIA DE APARTAMENTO	0.0000	288.8900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	11325	EQUIPO MACRO-GOTAS FLEXIVEL C/ INJETOR LATERAL UN	0.0000	1.5900	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	11325	EQUIPO MACRO-GOTAS FLEXIVEL C/ INJETOR LATERAL UN	0.0000	3.1800	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	00127	LUVA DE PROCEDIMENTO UNIDADE UN	0.0000	0.6700	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	00128	LUVA DE PROCEDIMENTO UNIDADE UN	0.0000	0.0000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	51649	ALCOOL ETILICO 70 % ST TP ML	0.0000	0.0300	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	51649	ALCOOL ETILICO 70 % ST TP ML	0.0000	0.0300	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	51649	ALCOOL ETILICO 70 % ST TP ML	0.0000	0.0300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	00090	SERINGA DESC 20 ML UN	0.0000	0.5400	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	00090	SERINGA DESC 20 ML UN	0.0000	0.5400	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	00090	SERINGA DESC 20 ML UN	0.0000	0.5400	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	00090	SERINGA DESC 20 ML UN	0.0000	0.5400	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	00090	SERINGA DESC 20 ML UN	0.0000	0.5400	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	00919	ALGODAO HIDROFILO BOLINHA UN	0.0000	0.2600	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	00919	ALGODAO HIDROFILO BOLINHA UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	f3ad474c8c562757c4d1a959ff0961c4	DJALMA	12718763240	NULL	12718763240	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	f3ad474c8c562757c4d1a959ff0961c4	DJALMA	12718763240	NULL	12718763240	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1800	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	f3ad474c8c562757c4d1a959ff0961c4	DJALMA	12718763240	NULL	12718763240	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1800	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	f3ad474c8c562757c4d1a959ff0961c4	DJALMA	12718763240	NULL	12718763240	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1800	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	f3ad474c8c562757c4d1a959ff0961c4	DJALMA	12718763240	NULL	12718763240	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1800	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	f3ad474c8c562757c4d1a959ff0961c4	DJALMA	12718763240	NULL	12718763240	51379	SERINGA DESC 05 ML UN	0.0000	0.1900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	f3ad474c8c562757c4d1a959ff0961c4	DJALMA	12718763240	NULL	12718763240	51584	ESPARADRAPO MICROPORE	0.0000	0.2600	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	f3ad474c8c562757c4d1a959ff0961c4	DJALMA	12718763240	NULL	12718763240	00090	SERINGA DESC 20 ML UN	0.0000	0.5400	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	f3ad474c8c562757c4d1a959ff0961c4	DJALMA	12718763240	NULL	12718763240	00090	SERINGA DESC 20 ML UN	0.0000	0.5400	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00090	SERINGA DESC 20 ML UN	0.5400	0.2200	0.3200	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.6900	0.2700	0.4200	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.6900	0.2700	0.4200	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.6900	0.2700	0.4200	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.6900	0.2700	0.4200	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.6900	0.2700	0.4200	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.6900	0.2700	0.4200	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	01062	CATETER OXIGENIO TIPO OCULOS UN	1.0000	0.3900	0.6100	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00128	LUVA DE PROCEDIMENTO UNIDADE UN	1.0000	0.3900	0.6100	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00493	BROMOPRIDA 5 MG/ML 2 ML SI IM IV AP	2.7300	1.0600	1.6700	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00493	BROMOPRIDA 5 MG/ML 2 ML SI IM IV AP	2.7300	1.0600	1.6700	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00124	LUVA CIRURGICA UN	2.9000	1.1300	1.7700	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	51163	AGUA BIDESTILADA 250 ML	5.7900	2.2600	3.5300	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	53144	TRAMAL	5.9900	2.3300	3.6600	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	53144	TRAMAL	5.9900	2.3300	3.6600	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00404	LACTULOSE 667 MG/ML XP VO ML	6.4300	2.5100	3.9200	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00613	CLINDAMICINA 600 MG 4 ML SI IM IV AP	13.0800	5.1000	7.9800	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00613	CLINDAMICINA 600 MG 4 ML SI IM IV AP	13.0800	5.1000	7.9800	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00613	CLINDAMICINA 600 MG 4 ML SI IM IV AP	13.0800	5.1000	7.9800	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	51673	ALGINATO DE CALCIO EM HIDROGEL GL TP GR	17.2500	6.7300	10.5200	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	16b1e9f62f247f02ad5cac910ee15b4e	BERCHOLINA	12631612848	NULL	12631612848	33537	PIPERACILINA 2 G + TAZOBACTAM 250 MG 30 ML	55.3400	55.3386	0.0014	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	16b1e9f62f247f02ad5cac910ee15b4e	BERCHOLINA	12631612848	NULL	12631612848	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4081	0.0019	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	16b1e9f62f247f02ad5cac910ee15b4e	BERCHOLINA	12631612848	NULL	12631612848	33219	LUVA DE PROCEDIMENTO UNIDADE UN	0.8370	1.0017	-0.3317	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	16b1e9f62f247f02ad5cac910ee15b4e	BERCHOLINA	12631612848	NULL	12631612848	36432	HIDROCLOROTIAZIDA 25 MG CP VO UN	0.2400	0.2300	0.0100	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	16b1e9f62f247f02ad5cac910ee15b4e	BERCHOLINA	12631612848	NULL	12631612848	00090	SERINGA DESC 20 ML UN	0.5400	0.5200	0.0200	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	16b1e9f62f247f02ad5cac910ee15b4e	BERCHOLINA	12631612848	NULL	12631612848	00090	SERINGA DESC 20 ML UN	0.5400	0.5200	0.0200	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	16b1e9f62f247f02ad5cac910ee15b4e	BERCHOLINA	12631612848	NULL	12631612848	00090	SERINGA DESC 20 ML UN	0.5400	0.5200	0.0200	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	16b1e9f62f247f02ad5cac910ee15b4e	BERCHOLINA	12631612848	NULL	12631612848	00406	FUROSEMIDA 10 MG/ML 2 ML SI IM IV AP	1.2000	1.1500	0.0500	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	16b1e9f62f247f02ad5cac910ee15b4e	BERCHOLINA	12631612848	NULL	12631612848	00406	FUROSEMIDA 10 MG/ML 2 ML SI IM IV AP	1.2000	1.1500	0.0500	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	16b1e9f62f247f02ad5cac910ee15b4e	BERCHOLINA	12631612848	NULL	12631612848	00171	SORO FISIOLOGICO 0,9% 250 ML SI IV BS	3.9400	3.7600	0.1800	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	16b1e9f62f247f02ad5cac910ee15b4e	BERCHOLINA	12631612848	NULL	12631612848	00171	SORO FISIOLOGICO 0,9% 250 ML SI IV BS	3.9400	3.7600	0.1800	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	dd6f8d6c53ffe9bfd3aa9590ba500cc8	ILDA	12751932542	NULL	12751932542	08648	ESPARADRAPO 10 X 4.5 CM CM	0.4000	0.2600	0.1400	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	dd6f8d6c53ffe9bfd3aa9590ba500cc8	ILDA	12751932542	NULL	12751932542	27545	CAMPO IODOFORADO UN	96.8000	0.0000	96.8000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	dd6f8d6c53ffe9bfd3aa9590ba500cc8	ILDA	12751932542	NULL	12751932542	08648	ESPARADRAPO 10 X 4.5 CM CM	0.4000	0.2600	0.1400	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	b288bbcfb9aecab51bcb0dba62ca0059	IVONETE	12743730847	NULL	12743730847	16853	PLACA P/ RECONSTRUÇAO DE ACETABULO UN	279.3000	0.0000	279.3000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	b288bbcfb9aecab51bcb0dba62ca0059	IVONETE	12743730847	NULL	12743730847	19216	SEVOFLURANO 1 ML/ML (100%) SL IN ML	301.8000	176.0500	125.7500	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12550571048	NULL	12550571048	00817	ALGODAO HIDROFILO BOLINHA UN	0.2600	0.1300	0.1300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12550571048	NULL	12550571048	00817	ALGODAO HIDROFILO BOLINHA UN	0.2600	0.1300	0.1300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12550571048	NULL	12550571048	32891	EQUIPO POLIFIX 2ş VIAS UN	2.5500	0.0000	2.5500	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12550571048	NULL	12550571048	05975	COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER	0.3000	0.1500	0.1500	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12550571048	NULL	12550571048	00817	ALGODAO HIDROFILO BOLINHA UN	0.5100	0.1300	0.3800	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12550571048	NULL	12550571048	00817	ALGODAO HIDROFILO BOLINHA UN	0.5100	0.1300	0.3800	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12550571048	NULL	12550571048	00817	ALGODAO HIDROFILO BOLINHA UN	0.5100	0.1300	0.3800	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12550571048	NULL	12550571048	00817	ALGODAO HIDROFILO BOLINHA UN	0.5100	0.1300	0.3800	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	52302	CLOREXIDINA SL TP BU ML	0.8000	0.6000	0.2000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	37761	ALCOOL ETILICO 70 % ST TP ML	0.0600	0.0300	0.0300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	75bcd473a0dc7c7a6751499b38a4a034	JOAQUIM	12692852143	NULL	12692852143	37761	ALCOOL ETILICO 70 % ST TP ML	0.0300	0.0200	0.0100	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	75bcd473a0dc7c7a6751499b38a4a034	JOAQUIM	12692852143	NULL	12692852143	37761	ALCOOL ETILICO 70 % ST TP ML	0.0300	0.0200	0.0100	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	75bcd473a0dc7c7a6751499b38a4a034	JOAQUIM	12692852143	NULL	12692852143	37761	ALCOOL ETILICO 70 % ST TP ML	0.0300	0.0200	0.0100	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	75bcd473a0dc7c7a6751499b38a4a034	JOAQUIM	12692852143	NULL	12692852143	08648	ESPARADRAPO 10 X 4.5 CM CM	0.4000	0.1000	0.3000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	4668d2494ed6c4b2d18be299efcb26a2	JOAO	12469689344	NULL	12469689344	13757	IODOPOVIDONA SD TP ML	0.6000	0.2000	0.4000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	33219	LUVA DE PROCEDIMENTO UNIDADE UN	1.0000	0.0000	1.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	22748	LIDOCAINA 2% GE TP OU GR	2.5900	0.0000	2.5900	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	20567	SORO FISIOLOGICO 0,9% 500 ML SI IV BS	4.7300	0.0000	4.7300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	22756	LIDOCAINA 2% S/ VASO SI PE ML	0.2300	0.0000	0.2300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	53660	EQUIPO MACRO-GOTAS FLEXIVEL C/ INJETOR LATE	1.5900	0.0000	1.5900	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	19160	SERINGA DESC 20 ML UN	0.5400	0.0000	0.5400	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	05975	COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER	0.0600	0.0000	0.0600	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	19151	SERINGA DESC 10 ML UN	0.3300	0.0000	0.3300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.0000	0.1000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12603877940	NULL	12603877940	37761	ALCOOL ETILICO 70 % ST TP ML	0.0600	0.0000	0.0600	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12603877940	NULL	12603877940	55018	ALGINATO DE CALCIO EM HIDROGEL GL TP GR	58.6500	0.0000	58.6500	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12603877940	NULL	12603877940	05444	CLORETO DE POTASSIO 15% 10 ML SI IV AP	0.6900	0.0000	0.6900	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12603877940	NULL	12603877940	33588	CLORETO DE SODIO 20% 10 ML SI IV AP	1.1000	0.0000	1.1000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12603877940	NULL	12603877940	53660	EQUIPO MACRO-GOTAS FLEXIVEL C/ INJETOR LATE	1.5900	0.0000	1.5900	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	00817	ALGODAO HIDROFILO BOLINHA UN	0.2600	0.1300	0.1300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	08664	ESPARADRAPO MICROPORE 50 X 10 CM CM	0.7700	0.2600	0.5100	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	37761	ALCOOL ETILICO 70 % ST TP ML	0.0300	0.0200	0.0100	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	00817	ALGODAO HIDROFILO BOLINHA UN	0.2600	0.1300	0.1300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	37761	ALCOOL ETILICO 70 % ST TP ML	0.0300	0.0200	0.0100	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	345c226bfea274af1372d41b0305a6c8	ALTINO	12720257940	NULL	12720257940	02917	ESCOPOLAMINA 10 MG + DIPIRONA 250 MG CP VO	0.4800	0.0000	0.4800	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.0000	0.1000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	33219	LUVA DE PROCEDIMENTO UNIDADE UN	1.0000	0.6700	0.3300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	37761	ALCOOL ETILICO 70 % ST TP ML	0.0300	0.0200	0.0100	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	22748	LIDOCAINA 2% GE TP OU GR	5.1900	1.3000	3.8900	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	33219	LUVA DE PROCEDIMENTO UNIDADE UN	1.0000	0.6700	0.3300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	55018	ALGINATO DE CALCIO EM HIDROGEL GL TP GR	6.9000	3.4500	3.4500	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	37761	ALCOOL ETILICO 70 % ST TP ML	0.0300	0.0200	0.0100	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12558131243	NULL	12558131243	11193	CLOREXIDINA 2 % ST TP ML	0.5300	0.2700	0.2600	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12558131243	NULL	12558131243	08648	ESPARADRAPO 10 X 4.5 CM CM	0.4000	0.2600	0.1400	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12558131243	NULL	12558131243	08664	ESPARADRAPO MICROPORE 50 X 10 CM CM	0.7700	0.2600	0.5100	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	37761	ALCOOL ETILICO 70 % ST TP ML	0.0300	0.0200	0.0100	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00817	ALGODAO HIDROFILO BOLINHA UN	0.2600	0.1300	0.1300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	7c2bc8cd9bbf9ce081562a3c63fff8c9	MARTA	12647505849	NULL	12647505849	20672	SORO RINGER SIMPLES 500 ML SI IV BS	17.8100	17.8000	0.0000	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	7c2bc8cd9bbf9ce081562a3c63fff8c9	MARTA	12647505849	NULL	12647505849	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1756	0.0044	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	f65f553befc0e3bc8bd5bce5c1c6e413	NAIRLENE	12633078944	NULL	12633078944	19160	SERINGA DESC 20 ML UN	0.5400	0.5367	0.0033	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	f65f553befc0e3bc8bd5bce5c1c6e413	NAIRLENE	12633078944	NULL	12633078944	19160	SERINGA DESC 20 ML UN	0.5400	0.5367	0.0033	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	f65f553befc0e3bc8bd5bce5c1c6e413	NAIRLENE	12633078944	NULL	12633078944	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1760	0.0040	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	f65f553befc0e3bc8bd5bce5c1c6e413	NAIRLENE	12633078944	NULL	12633078944	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1760	0.0040	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	f65f553befc0e3bc8bd5bce5c1c6e413	NAIRLENE	12633078944	NULL	12633078944	07269	DIPIRONA 500 MG/ML 2 ML SI IV IM AP	0.6900	0.6867	0.0033	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	f93cee6f501560245a8f94ffc5c6c246	ROSEDALIA	12622895145	NULL	12622895145	19160	SERINGA DESC 20 ML UN	0.5400	0.5373	0.0027	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	d4089ccef13567fd45b16fb0b60685fa	VERA	12640482546	NULL	12640482546	27480	CLARITROMICINA 500 MG 30 ML PO IV FA	117.1100	117.1050	0.0050	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	d4089ccef13567fd45b16fb0b60685fa	VERA	12640482546	NULL	12640482546	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1754	0.0046	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	d4089ccef13567fd45b16fb0b60685fa	VERA	12640482546	NULL	12640482546	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1754	0.0046	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	d4089ccef13567fd45b16fb0b60685fa	VERA	12640482546	NULL	12640482546	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1754	0.0046	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	d4089ccef13567fd45b16fb0b60685fa	VERA	12640482546	NULL	12640482546	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1754	0.0046	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	eecb3d883747b059c3fe231c34567476	AFFRIDES	12693180144	NULL	12693180144	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4074	0.0026	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	eecb3d883747b059c3fe231c34567476	AFFRIDES	12693180144	NULL	12693180144	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4074	0.0026	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	eecb3d883747b059c3fe231c34567476	AFFRIDES	12693180144	NULL	12693180144	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4074	0.0026	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	eecb3d883747b059c3fe231c34567476	AFFRIDES	12693180144	NULL	12693180144	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4074	0.0026	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	eecb3d883747b059c3fe231c34567476	AFFRIDES	12693180144	NULL	12693180144	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4074	0.0026	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	eecb3d883747b059c3fe231c34567476	AFFRIDES	12693180144	NULL	12693180144	19160	SERINGA DESC 20 ML UN	0.5400	0.5372	0.0028	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	eecb3d883747b059c3fe231c34567476	AFFRIDES	12693180144	NULL	12693180144	19160	SERINGA DESC 20 ML UN	0.5400	0.5372	0.0028	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	eecb3d883747b059c3fe231c34567476	AFFRIDES	12693180144	NULL	12693180144	19160	SERINGA DESC 20 ML UN	0.5400	0.5372	0.0028	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	eecb3d883747b059c3fe231c34567476	AFFRIDES	12693180144	NULL	12693180144	19160	SERINGA DESC 20 ML UN	0.5400	0.5372	0.0028	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	eecb3d883747b059c3fe231c34567476	AFFRIDES	12693180144	NULL	12693180144	19160	SERINGA DESC 20 ML UN	0.5400	0.5372	0.0028	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	eecb3d883747b059c3fe231c34567476	AFFRIDES	12693180144	NULL	12693180144	19160	SERINGA DESC 20 ML UN	0.5400	0.5372	0.0028	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	eecb3d883747b059c3fe231c34567476	AFFRIDES	12693180144	NULL	12693180144	19160	SERINGA DESC 20 ML UN	0.5400	0.5372	0.0028	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1d6bbb4a00130e2e654e830fc9bae6a	ALEXANDRINA	12694224940	NULL	12694224940	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4072	0.0028	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1d6bbb4a00130e2e654e830fc9bae6a	ALEXANDRINA	12694224940	NULL	12694224940	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4072	0.0028	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1d6bbb4a00130e2e654e830fc9bae6a	ALEXANDRINA	12694224940	NULL	12694224940	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4072	0.0028	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1d6bbb4a00130e2e654e830fc9bae6a	ALEXANDRINA	12694224940	NULL	12694224940	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4072	0.0028	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1d6bbb4a00130e2e654e830fc9bae6a	ALEXANDRINA	12694224940	NULL	12694224940	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4072	0.0028	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1d6bbb4a00130e2e654e830fc9bae6a	ALEXANDRINA	12694224940	NULL	12694224940	19160	SERINGA DESC 20 ML UN	0.5400	0.5367	0.0033	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1d6bbb4a00130e2e654e830fc9bae6a	ALEXANDRINA	12694224940	NULL	12694224940	19160	SERINGA DESC 20 ML UN	0.5400	0.5367	0.0033	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1d6bbb4a00130e2e654e830fc9bae6a	ALEXANDRINA	12694224940	NULL	12694224940	19160	SERINGA DESC 20 ML UN	0.5400	0.5367	0.0033	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1d6bbb4a00130e2e654e830fc9bae6a	ALEXANDRINA	12694224940	NULL	12694224940	19160	SERINGA DESC 20 ML UN	0.5400	0.5367	0.0033	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1d6bbb4a00130e2e654e830fc9bae6a	ALEXANDRINA	12694224940	NULL	12694224940	19160	SERINGA DESC 20 ML UN	0.5400	0.5367	0.0033	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1d6bbb4a00130e2e654e830fc9bae6a	ALEXANDRINA	12694224940	NULL	12694224940	19160	SERINGA DESC 20 ML UN	0.5400	0.5367	0.0033	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1d6bbb4a00130e2e654e830fc9bae6a	ALEXANDRINA	12694224940	NULL	12694224940	19160	SERINGA DESC 20 ML UN	0.5400	0.5367	0.0033	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1d6bbb4a00130e2e654e830fc9bae6a	ALEXANDRINA	12694224940	NULL	12694224940	19160	SERINGA DESC 20 ML UN	1.0800	1.0733	0.0067	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	345c226bfea274af1372d41b0305a6c8	ALTINO	12720257940	NULL	12720257940	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.1000	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	345c226bfea274af1372d41b0305a6c8	ALTINO	12720257940	NULL	12720257940	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.1000	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.1038	-0.0038	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.1038	-0.0038	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.1038	-0.0038	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.1038	-0.0038	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	19160	SERINGA DESC 20 ML UN	0.5400	0.5378	0.0022	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	19160	SERINGA DESC 20 ML UN	0.5400	0.5378	0.0022	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1797	0.0003	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1797	0.0003	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1797	0.0003	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	00426	AGUA BIDESTILADA 10 ML SI IV IM AP	0.4000	0.4045	-0.0045	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	00426	AGUA BIDESTILADA 10 ML SI IV IM AP	0.4000	0.4045	-0.0045	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	00426	AGUA BIDESTILADA 10 ML SI IV IM AP	0.8100	0.8091	0.0009	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	20567	SORO FISIOLOGICO 0,9% 500 ML SI IV BS	4.7300	4.7350	-0.0050	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12550571048	NULL	12550571048	05975	COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER	0.6000	0.1500	0.4500	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12550571048	NULL	12550571048	05975	COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER	0.6000	0.1500	0.4500	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12550571048	NULL	12550571048	05975	COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER	0.3000	0.0000	0.3000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	670141098c0309ac9be3db204bdc12cf	LEOSINA	12706525442	NULL	12706525442	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1767	0.0033	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	670141098c0309ac9be3db204bdc12cf	LEOSINA	12706525442	NULL	12706525442	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1767	0.0033	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	670141098c0309ac9be3db204bdc12cf	LEOSINA	12706525442	NULL	12706525442	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1767	0.0033	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	670141098c0309ac9be3db204bdc12cf	LEOSINA	12706525442	NULL	12706525442	02461	FENOTEROL 2 MG/ML 10 ML AE IN DS	0.4300	0.4250	0.0050	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	670141098c0309ac9be3db204bdc12cf	LEOSINA	12706525442	NULL	12706525442	02461	FENOTEROL 2 MG/ML 10 ML AE IN DS	0.4300	0.4250	0.0050	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	20cbe2e07b1dcd2b6af609a50df7ae80	LUCELENA	12690767849	NULL	12690767849	37761	ALCOOL ETILICO 70 % ST TP ML	0.0600	0.0300	0.0300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	20cbe2e07b1dcd2b6af609a50df7ae80	LUCELENA	12690767849	NULL	12690767849	27480	CLARITROMICINA 500 MG 30 ML PO IV FA	117.1100	117.1050	0.0050	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	20cbe2e07b1dcd2b6af609a50df7ae80	LUCELENA	12690767849	NULL	12690767849	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1758	0.0042	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	20cbe2e07b1dcd2b6af609a50df7ae80	LUCELENA	12690767849	NULL	12690767849	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1758	0.0042	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	20cbe2e07b1dcd2b6af609a50df7ae80	LUCELENA	12690767849	NULL	12690767849	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1758	0.0042	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	20cbe2e07b1dcd2b6af609a50df7ae80	LUCELENA	12690767849	NULL	12690767849	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1758	0.0042	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	20cbe2e07b1dcd2b6af609a50df7ae80	LUCELENA	12690767849	NULL	12690767849	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1758	0.0042	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	20cbe2e07b1dcd2b6af609a50df7ae80	LUCELENA	12690767849	NULL	12690767849	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1758	0.0042	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	20cbe2e07b1dcd2b6af609a50df7ae80	LUCELENA	12690767849	NULL	12690767849	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1758	0.0042	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	20cbe2e07b1dcd2b6af609a50df7ae80	LUCELENA	12690767849	NULL	12690767849	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4072	0.0028	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	20cbe2e07b1dcd2b6af609a50df7ae80	LUCELENA	12690767849	NULL	12690767849	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4084	0.0016	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	20cbe2e07b1dcd2b6af609a50df7ae80	LUCELENA	12690767849	NULL	12690767849	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4084	0.0016	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	20cbe2e07b1dcd2b6af609a50df7ae80	LUCELENA	12690767849	NULL	12690767849	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4084	0.0016	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	20cbe2e07b1dcd2b6af609a50df7ae80	LUCELENA	12690767849	NULL	12690767849	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4084	0.0016	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	20cbe2e07b1dcd2b6af609a50df7ae80	LUCELENA	12690767849	NULL	12690767849	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4084	0.0016	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	20cbe2e07b1dcd2b6af609a50df7ae80	LUCELENA	12690767849	NULL	12690767849	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4084	0.0016	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	20cbe2e07b1dcd2b6af609a50df7ae80	LUCELENA	12690767849	NULL	12690767849	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4084	0.0016	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	20cbe2e07b1dcd2b6af609a50df7ae80	LUCELENA	12690767849	NULL	12690767849	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4084	0.0016	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	20cbe2e07b1dcd2b6af609a50df7ae80	LUCELENA	12690767849	NULL	12690767849	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4084	0.0016	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	20cbe2e07b1dcd2b6af609a50df7ae80	LUCELENA	12690767849	NULL	12690767849	19160	SERINGA DESC 20 ML UN	0.5400	0.5384	0.0016	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	20cbe2e07b1dcd2b6af609a50df7ae80	LUCELENA	12690767849	NULL	12690767849	19160	SERINGA DESC 20 ML UN	0.5400	0.5384	0.0016	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	20cbe2e07b1dcd2b6af609a50df7ae80	LUCELENA	12690767849	NULL	12690767849	19160	SERINGA DESC 20 ML UN	0.5400	0.5384	0.0016	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	49824	NISTATINA 100.000 UI SU VO ML	0.3000	0.3000	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	19445	CLORETO DE POTASSIO 600 MG CA VO UN	0.4900	0.4867	0.0033	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	19445	CLORETO DE POTASSIO 600 MG CA VO UN	0.4900	0.4867	0.0033	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	19445	CLORETO DE POTASSIO 600 MG CA VO UN	0.4900	0.4867	0.0033	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	19445	CLORETO DE POTASSIO 600 MG CA VO UN	0.4900	0.4867	0.0033	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	19445	CLORETO DE POTASSIO 600 MG CA VO UN	0.4900	0.4867	0.0033	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4075	0.0025	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4075	0.0025	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4075	0.0025	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	07269	DIPIRONA 500 MG/ML 2 ML SI IV IM AP	0.6900	0.6865	0.0035	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	07269	DIPIRONA 500 MG/ML 2 ML SI IV IM AP	0.6900	0.6865	0.0035	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	07269	DIPIRONA 500 MG/ML 2 ML SI IV IM AP	0.6900	0.6865	0.0035	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	19160	SERINGA DESC 20 ML UN	0.5400	0.5375	0.0025	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	19160	SERINGA DESC 20 ML UN	0.5400	0.5375	0.0025	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1769	0.0031	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1769	0.0031	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1769	0.0031	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1769	0.0031	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00426	AGUA BIDESTILADA 10 ML SI IV IM AP	0.8100	0.8073	0.0027	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00426	AGUA BIDESTILADA 10 ML SI IV IM AP	0.8100	0.8073	0.0027	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	19160	SERINGA DESC 20 ML UN	0.5400	0.5372	0.0028	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1779	0.0021	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1779	0.0021	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1779	0.0021	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1779	0.0021	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	00426	AGUA BIDESTILADA 10 ML SI IV IM AP	0.8100	0.8092	0.0008	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	11193	CLOREXIDINA 2 % ST TP ML	0.5300	0.5320	-0.0020	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	08664	ESPARADRAPO MICROPORE 50 X 10 CM CM	0.2600	0.2550	0.0050	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	08664	ESPARADRAPO MICROPORE 50 X 10 CM CM	0.2600	0.2558	0.0042	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	08664	ESPARADRAPO MICROPORE 50 X 10 CM CM	0.2600	0.2558	0.0042	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	08664	ESPARADRAPO MICROPORE 50 X 10 CM CM	0.2600	0.2558	0.0042	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	e2b254ce765be196b019032789d8f852	MARIA	12576216044	NULL	12576216044	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4078	0.0022	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	e2b254ce765be196b019032789d8f852	MARIA	12576216044	NULL	12576216044	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4078	0.0022	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	32891	EQUIPO POLIFIX 2ş VIAS UN	2.5500	0.0000	2.5500	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	08664	ESPARADRAPO MICROPORE 50 X 10 CM CM	0.7700	0.7650	0.0050	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	37761	ALCOOL ETILICO 70 % ST TP ML	0.0300	0.0000	0.0300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	d17b3c5ae418d82694895a326dee545a	ODILIA	12670516743	NULL	12670516743	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1774	0.0026	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	d17b3c5ae418d82694895a326dee545a	ODILIA	12670516743	NULL	12670516743	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1774	0.0026	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	d17b3c5ae418d82694895a326dee545a	ODILIA	12670516743	NULL	12670516743	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1774	0.0026	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	d17b3c5ae418d82694895a326dee545a	ODILIA	12670516743	NULL	12670516743	22748	LIDOCAINA 2% GE TP OU GR	5.1900	2.5900	2.6000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	6ccea6ac8c216c032723aee73a9f81c9	PRISCILA	12662249242	NULL	12662249242	07269	DIPIRONA 500 MG/ML 2 ML SI IV IM AP	0.6900	0.6864	0.0036	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	6ccea6ac8c216c032723aee73a9f81c9	PRISCILA	12662249242	NULL	12662249242	07269	DIPIRONA 500 MG/ML 2 ML SI IV IM AP	0.6900	0.6864	0.0036	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	6ccea6ac8c216c032723aee73a9f81c9	PRISCILA	12662249242	NULL	12662249242	19160	SERINGA DESC 20 ML UN	0.5400	0.5370	0.0030	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.1000	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.1000	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.1000	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.1000	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.1000	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00426	AGUA BIDESTILADA 10 ML SI IV IM AP	0.4000	0.0000	0.4000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1766	0.0034	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	33227	LUVA CIRURGICA PAR UN	1.4500	1.4476	0.0024	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	33227	LUVA CIRURGICA PAR UN	1.4500	1.4476	0.0024	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	33227	LUVA CIRURGICA PAR UN	1.4500	1.4476	0.0024	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	33227	LUVA CIRURGICA PAR UN	1.4500	1.4476	0.0024	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	19160	SERINGA DESC 20 ML UN	0.5400	0.5384	0.0016	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	19160	SERINGA DESC 20 ML UN	0.5400	0.5384	0.0016	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	19160	SERINGA DESC 20 ML UN	0.5400	0.5384	0.0016	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	19160	SERINGA DESC 20 ML UN	0.5400	0.5384	0.0016	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1764	0.0036	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1776	0.0024	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1776	0.0024	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1776	0.0024	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1776	0.0024	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1776	0.0024	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1776	0.0024	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	53660	EQUIPO MACRO-GOTAS FLEXIVEL C/ INJETOR LATE	1.5900	1.5900	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	00426	AGUA BIDESTILADA 10 ML SI IV IM AP	0.8100	0.8092	0.0008	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	6799aa3de305405ab065aad5b599765c	VANIR	12700232345	NULL	12700232345	07269	DIPIRONA 500 MG/ML 2 ML SI IV IM AP	0.6900	0.6870	0.0030	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	6799aa3de305405ab065aad5b599765c	VANIR	12700232345	NULL	12700232345	07269	DIPIRONA 500 MG/ML 2 ML SI IV IM AP	0.6900	0.6870	0.0030	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	6799aa3de305405ab065aad5b599765c	VANIR	12700232345	NULL	12700232345	07269	DIPIRONA 500 MG/ML 2 ML SI IV IM AP	0.6900	0.6870	0.0030	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	0111beed375944f60c7ad4a7fd4874f8	WALDIR	12746025744	NULL	12746025744	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1773	0.0027	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	610c198ec4c064687cf0524f147d3aed	ROBERTO	12748814743	NULL	12748814743	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4080	0.0020	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	610c198ec4c064687cf0524f147d3aed	ROBERTO	12748814743	NULL	12748814743	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1767	0.0033	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	610c198ec4c064687cf0524f147d3aed	ROBERTO	12748814743	NULL	12748814743	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1767	0.0033	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	610c198ec4c064687cf0524f147d3aed	ROBERTO	12748814743	NULL	12748814743	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1767	0.0033	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	610c198ec4c064687cf0524f147d3aed	ROBERTO	12748814743	NULL	12748814743	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1767	0.0033	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	610c198ec4c064687cf0524f147d3aed	ROBERTO	12748814743	NULL	12748814743	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4091	0.0009	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	610c198ec4c064687cf0524f147d3aed	ROBERTO	12748814743	NULL	12748814743	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4083	0.0017	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	610c198ec4c064687cf0524f147d3aed	ROBERTO	12748814743	NULL	12748814743	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4083	0.0017	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	610c198ec4c064687cf0524f147d3aed	ROBERTO	12748814743	NULL	12748814743	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4083	0.0017	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12647284040	NULL	12647284040	00817	ALGODAO HIDROFILO BOLINHA UN	0.1300	0.1200	0.0000	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12647284040	NULL	12647284040	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1750	0.0050	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12647284040	NULL	12647284040	08664	ESPARADRAPO MICROPORE 50 X 10 CM CM	0.7700	0.7667	0.0033	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12647284040	NULL	12647284040	08664	ESPARADRAPO MICROPORE 50 X 10 CM CM	0.7700	0.7667	0.0033	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12647284040	NULL	12647284040	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4086	0.0014	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12647284040	NULL	12647284040	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4086	0.0014	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12647284040	NULL	12647284040	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4086	0.0014	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12647284040	NULL	12647284040	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4086	0.0014	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12647284040	NULL	12647284040	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4086	0.0014	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12647284040	NULL	12647284040	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4086	0.0014	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12647284040	NULL	12647284040	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4086	0.0014	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12647284040	NULL	12647284040	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4086	0.0014	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1770	0.0030	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	75bcd473a0dc7c7a6751499b38a4a034	JOAQUIM	12692852143	NULL	12692852143	00817	ALGODAO HIDROFILO BOLINHA UN	0.3800	0.1300	0.2500	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	01081197	39df67956a358bf1eab89803158d25dd	HELENA	12655839525	NULL	12655839525	34010130	TOMOGRAFIA COMPUTADORIZADA DO TORAX	0.0000	280.6875	NULL	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	01081197	d976e4891c20ce18571e41a3ef37b382	SEBASTIAO	12668979425	NULL	12668979425	34010130	TOMOGRAFIA COMPUTADORIZADA DO TORAX	0.0000	280.6875	NULL	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	11193	CLOREXIDINA 2 % ST TP ML	0.5300	0.0000	0.5300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	50644	MORFINA 10 MG/ML 1 ML SI IM IV PE IT AP	2.6400	2.6400	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	33545	PIPERACILINA 4 G + TAZOBACTAM 500 MG PO IV	83.4500	83.4500	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	33545	PIPERACILINA 4 G + TAZOBACTAM 500 MG PO IV	83.4500	83.4500	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	33545	PIPERACILINA 4 G + TAZOBACTAM 500 MG PO IV	83.4500	83.4500	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	6.8145	-3.4045	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	6.8145	-3.4045	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	6.8145	-3.4045	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4072	0.0028	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4072	0.0028	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4072	0.0028	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4072	0.0028	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4072	0.0028	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4072	0.0028	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	33227	LUVA CIRURGICA PAR UN	2.9000	2.9000	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	33227	LUVA CIRURGICA PAR UN	2.9000	2.9000	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.2120	-0.1120	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.2120	-0.1120	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	19160	SERINGA DESC 20 ML UN	0.5400	0.5374	0.0026	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	19160	SERINGA DESC 20 ML UN	0.5400	0.5374	0.0026	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	19160	SERINGA DESC 20 ML UN	0.5400	0.5374	0.0026	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	19160	SERINGA DESC 20 ML UN	0.5400	0.5374	0.0026	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	19160	SERINGA DESC 20 ML UN	0.5400	0.5374	0.0026	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00426	AGUA BIDESTILADA 10 ML SI IV IM AP	0.4000	0.4037	-0.0037	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00426	AGUA BIDESTILADA 10 ML SI IV IM AP	0.4000	0.4037	-0.0037	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00426	AGUA BIDESTILADA 10 ML SI IV IM AP	0.4000	0.4037	-0.0037	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00426	AGUA BIDESTILADA 10 ML SI IV IM AP	0.4000	0.4037	-0.0037	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00426	AGUA BIDESTILADA 10 ML SI IV IM AP	0.4000	0.4037	-0.0037	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00426	AGUA BIDESTILADA 10 ML SI IV IM AP	0.8100	0.8073	0.0027	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00426	AGUA BIDESTILADA 10 ML SI IV IM AP	0.8100	0.8073	0.0027	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00426	AGUA BIDESTILADA 10 ML SI IV IM AP	0.8100	0.8073	0.0027	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00426	AGUA BIDESTILADA 10 ML SI IV IM AP	0.8100	0.8073	0.0027	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	33219	LUVA DE PROCEDIMENTO UNIDADE UN	1.0000	1.0050	-0.0050	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	09636	FLORATIL (SACCHAROMYCES BOULARDII) 200 MG P	4.4400	8.8851	-4.4451	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	09636	FLORATIL (SACCHAROMYCES BOULARDII) 200 MG P	4.4400	8.8851	-4.4451	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	09636	FLORATIL (SACCHAROMYCES BOULARDII) 200 MG P	4.4400	8.8851	-4.4451	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	27600	ONDANSETRONA 2 MG/ML 4 ML SI IM IV AP	81.1800	94.7100	-81.1800	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	05975	COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER	0.7739	0.8059	-0.7759	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	05975	COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER	1.3439	1.3948	-0.7948	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	05975	COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER	1.3439	1.3948	-0.7948	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	28959	DERSANI LC TP ML	5.8200	6.7900	-4.8500	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	55018	ALGINATO DE CALCIO EM HIDROGEL GL TP GR	58.6500	58.6500	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	08664	ESPARADRAPO MICROPORE 50 X 10 CM CM	1.3564	1.3849	-0.8749	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	05444	CLORETO DE POTASSIO 15% 10 ML SI IV AP	17.1400	13.7200	3.4200	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1d6bbb4a00130e2e654e830fc9bae6a	ALEXANDRINA	12694224940	NULL	12694224940	05274	AMOXICILINA 500 MG + CLAVULANATO 125 MG CP	3.1700	3.1667	0.0033	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	03280	CLOREXIDINA 2 % ST TP ML	NULL	0.0000	NULL	OPME INVALIDO	2201
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	52733	SERINGA DESC 20 ML UN	NULL	0.0000	NULL	OPME INVALIDO	2201
Glosa Min	2018-10-03 00:00:00.000000	1084117	800720d33fe0defb6121e82dd216d044	JALMO	12786952647	NULL	12786952647	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1800	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	800720d33fe0defb6121e82dd216d044	JALMO	12786952647	NULL	12786952647	00757	CEFUROXIMA 750 MG + DIL. 6 ML PO IM IV FA	0.0000	26.1300	NULL	VALOR APRESENTADO A MAIOR	1705
Glosa Min	2018-10-03 00:00:00.000000	1084117	752c651cb4fd049e19c685f87fbe8bdc	EDUARDO	12765990646	NULL	12765990646	27060012	Unidade de Concentrado Hemácias	0.0000	0.0000	NULL	OPME PAGO A FORNECEDOR TERCEIRIZADO	2213
Glosa Min	2018-10-03 00:00:00.000000	1084117	752c651cb4fd049e19c685f87fbe8bdc	EDUARDO	12765990646	NULL	12765990646	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.0000	0.6875	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	752c651cb4fd049e19c685f87fbe8bdc	EDUARDO	12765990646	NULL	12765990646	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.0000	0.6875	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	752c651cb4fd049e19c685f87fbe8bdc	EDUARDO	12765990646	NULL	12765990646	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.0000	0.6875	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	752c651cb4fd049e19c685f87fbe8bdc	EDUARDO	12765990646	NULL	12765990646	000441	TAXA DE DELEUCOTIZAÇÃO	0.0000	0.0000	NULL	OPME PAGO A FORNECEDOR TERCEIRIZADO	2213
Glosa Min	2018-10-03 00:00:00.000000	1084117	752c651cb4fd049e19c685f87fbe8bdc	EDUARDO	12765990646	NULL	12765990646	51208	SORO RINGER SIMPLES 500 ML SI IV BS	0.0000	5.9400	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	752c651cb4fd049e19c685f87fbe8bdc	EDUARDO	12765990646	NULL	12765990646	53975	Hemifumarato De Quetiapina 25mg ? Cp	0.0000	1.2450	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12558131243	NULL	12558131243	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12558131243	NULL	12558131243	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1757	NULL	VALOR APRESENTADO A MAIOR	1705
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12558131243	NULL	12558131243	52010341	Hérnia Discal - Tratamento Cirúrgico	0.0000	0.0000	NULL	COBRANCA DE HONORARIOS EM DUPLICIDADE	2607
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12558131243	NULL	12558131243	00657	CEFAZOLINA 1 GR + DIL. 10 ML PO IM IV FA	0.0000	8.1200	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	526685c1041cc1316e874a2e95e67e2e	JOSE	12696604949	NULL	12696604949	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1760	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	526685c1041cc1316e874a2e95e67e2e	JOSE	12696604949	NULL	12696604949	52733	SERINGA DESC 20 ML UN	0.0000	0.5365	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	526685c1041cc1316e874a2e95e67e2e	JOSE	12696604949	NULL	12696604949	55010288	Transplante Pulmonar Total Unilateral (Doador)	0.0000	0.0000	NULL	COBRANCA DE HONORARIOS EM DUPLICIDADE	2607
Glosa Min	2018-10-03 00:00:00.000000	1084117	526685c1041cc1316e874a2e95e67e2e	JOSE	12696604949	NULL	12696604949	00090	SERINGA DESC 20 ML UN	0.0000	0.5367	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	526685c1041cc1316e874a2e95e67e2e	JOSE	12696604949	NULL	12696604949	00090	SERINGA DESC 20 ML UN	0.0000	0.5367	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	11232	CLEXANE (ENOXAPARINA) 40 MG SI IV SC SE	0.0000	38.9400	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	11232	CLEXANE (ENOXAPARINA) 40 MG SI IV SC SE	0.0000	38.9400	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.0000	1.3700	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	000501	OXIGENIO	0.0000	982.8200	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.0000	0.0000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.0000	0.0000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.0000	0.4000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.0000	0.4000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.0000	0.4000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.0000	0.4000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.0000	0.4000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.0000	0.4000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	51163	AGUA BIDESTILADA 250 ML	0.0000	5.7900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	51379	SERINGA DESC 05 ML UN	0.0000	0.1900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	51379	SERINGA DESC 05 ML UN	0.0000	0.1900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	51379	SERINGA DESC 05 ML UN	0.0000	0.1900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	51434	BECLOMETASONA 400 MCG / ML 2 ML SL IN FL	0.0000	4.4800	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	51434	BECLOMETASONA 400 MCG / ML 2 ML SL IN FL	0.0000	4.4800	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	51434	BECLOMETASONA 400 MCG / ML 2 ML SL IN FL	0.0000	4.4800	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	51434	BECLOMETASONA 400 MCG / ML 2 ML SL IN FL	0.0000	4.4800	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	51660	BROMETO DE IPRATROPIO SL IN GT	0.0000	0.0000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	51660	BROMETO DE IPRATROPIO SL IN GT	0.0000	0.0000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	51660	BROMETO DE IPRATROPIO SL IN GT	0.0000	0.0000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	51708	Dieta Hipercalorica Hiperproteica Sem Fibras 1.5 kcal	0.0000	73.4000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00091	SERINGA DESC 01 ML (INSULINA) UN	0.0000	0.3057	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	2.5500	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	35382	COMPRESSAS DE GASES 7.5 X7,5 (11 FIOS ESTERIL) UN	0.0000	0.0000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	4e13adf421809cb755e1bdd80cc4efed	AGRIPINA	12385409142	NULL	12385409142	000501	OXIGENIO	0.0000	5.2000	NULL	COBRANCA DE GASES INCOMPATIVEL COM O UTILIZADO/ PRESCRITO	2310
Glosa Min	2018-10-03 00:00:00.000000	1084117	4e13adf421809cb755e1bdd80cc4efed	AGRIPINA	12385409142	NULL	12385409142	51649	ALCOOL ETILICO 70 % ST TP ML	0.0000	0.0300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	75bcd473a0dc7c7a6751499b38a4a034	JOAQUIM	12692852143	NULL	12692852143	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4075	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	75bcd473a0dc7c7a6751499b38a4a034	JOAQUIM	12692852143	NULL	12692852143	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4075	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	75bcd473a0dc7c7a6751499b38a4a034	JOAQUIM	12692852143	NULL	12692852143	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4075	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	75bcd473a0dc7c7a6751499b38a4a034	JOAQUIM	12692852143	NULL	12692852143	01652	TRAMADOL 50 MG CP VO UN	0.0000	1.9276	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	75bcd473a0dc7c7a6751499b38a4a034	JOAQUIM	12692852143	NULL	12692852143	01652	TRAMADOL 50 MG CP VO UN	0.0000	1.9272	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	75bcd473a0dc7c7a6751499b38a4a034	JOAQUIM	12692852143	NULL	12692852143	01652	TRAMADOL 50 MG CP VO UN	0.0000	1.9272	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	75bcd473a0dc7c7a6751499b38a4a034	JOAQUIM	12692852143	NULL	12692852143	00172	SORO FISIOLOGICO 0,9% 500 ML SI IV BS	0.0000	4.7300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	75bcd473a0dc7c7a6751499b38a4a034	JOAQUIM	12692852143	NULL	12692852143	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.0000	0.6850	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	75bcd473a0dc7c7a6751499b38a4a034	JOAQUIM	12692852143	NULL	12692852143	04073	TRAMADOL 50 MG 1 ML SI IM IV AP	0.0000	4.1900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	75bcd473a0dc7c7a6751499b38a4a034	JOAQUIM	12692852143	NULL	12692852143	04073	TRAMADOL 50 MG 1 ML SI IM IV AP	0.0000	4.1900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	75bcd473a0dc7c7a6751499b38a4a034	JOAQUIM	12692852143	NULL	12692852143	04073	TRAMADOL 50 MG 1 ML SI IM IV AP	0.0000	4.1900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	75bcd473a0dc7c7a6751499b38a4a034	JOAQUIM	12692852143	NULL	12692852143	04073	TRAMADOL 50 MG 1 ML SI IM IV AP	0.0000	4.1900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	75bcd473a0dc7c7a6751499b38a4a034	JOAQUIM	12692852143	NULL	12692852143	04073	TRAMADOL 50 MG 1 ML SI IM IV AP	0.0000	4.1900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00124	LUVA CIRURGICA UN	0.0000	1.4475	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	24082	BROMOPRIDA 5 MG/ML 2 ML SI IM IV AP	0.0000	2.7300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	24082	BROMOPRIDA 5 MG/ML 2 ML SI IM IV AP	0.0000	2.7300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	26981	SORO FISIOLOGICO 0,9% 10 ML SI IV AP	0.0000	0.9600	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.0000	0.6875	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.0000	0.6875	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.0000	0.6900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00487	RANITIDINA 25 MG/ML 2 ML SI IM IV AP	0.0000	0.9300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00487	RANITIDINA 25 MG/ML 2 ML SI IM IV AP	0.0000	0.9300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00487	RANITIDINA 25 MG/ML 2 ML SI IM IV AP	0.0000	0.9300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	51584	ESPARADRAPO MICROPORE	0.0000	0.2560	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	51584	ESPARADRAPO MICROPORE	0.0000	0.2560	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	51584	ESPARADRAPO MICROPORE	0.0000	0.0260	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	54756	HIDANTAL	0.0000	0.1864	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00796	FLORATIL (SACCHAROMYCES BOULARDII) 200 MG PO VO	0.0000	4.4400	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4088	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4088	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4088	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4088	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4088	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4088	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.0000	0.6872	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.0000	0.6872	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.0000	0.0000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1800	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1766	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1766	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1766	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1766	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1766	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1766	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4070	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	22421	PIPERACILINA 2 G + TAZOBACTAM 250 MG 30 ML PO IV	0.0000	55.3400	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	22421	PIPERACILINA 2 G + TAZOBACTAM 250 MG 30 ML PO IV	0.0000	55.3400	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	35382	COMPRESSAS DE GASES 7.5 X7,5 (11 FIOS ESTERIL) UN	0.0000	0.3000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	51508	ENCRISE (ARGIPRESSINA) 20 U/ML 1 ML SI IM IV SC AP	0.0000	20.1200	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	51508	ENCRISE (ARGIPRESSINA) 20 U/ML 1 ML SI IM IV SC AP	0.0000	40.2400	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	51584	ESPARADRAPO MICROPORE	0.0000	0.2560	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	51584	ESPARADRAPO MICROPORE	0.0000	0.2560	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	cd2840524be5a3f1d0939f241e24f32b	MARIA	12705908340	NULL	12705908340	00181	SULFATO DE MAGNESIO 100 MG/ML 10 ML SI IM IV	0.0000	0.9467	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	cd2840524be5a3f1d0939f241e24f32b	MARIA	12705908340	NULL	12705908340	00184	CLORETO DE POTASSIO 10% 10 ML SI IV AP	0.0000	0.2967	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	cd2840524be5a3f1d0939f241e24f32b	MARIA	12705908340	NULL	12705908340	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	cd2840524be5a3f1d0939f241e24f32b	MARIA	12705908340	NULL	12705908340	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	cd2840524be5a3f1d0939f241e24f32b	MARIA	12705908340	NULL	12705908340	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	cd2840524be5a3f1d0939f241e24f32b	MARIA	12705908340	NULL	12705908340	00090	SERINGA DESC 20 ML UN	0.0000	0.5367	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12550571048	NULL	12550571048	51240	FITA ADVANTAGE P/ GLICOSE UN	0.0000	3.1200	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12550571048	NULL	12550571048	00090	SERINGA DESC 20 ML UN	0.0000	0.5379	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12550571048	NULL	12550571048	00090	SERINGA DESC 20 ML UN	0.0000	0.5379	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12550571048	NULL	12550571048	00090	SERINGA DESC 20 ML UN	0.0000	0.5379	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12550571048	NULL	12550571048	00091	SERINGA DESC 01 ML (INSULINA) UN	0.0000	0.6000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	9ffbbf7340bbd65e9e3baa9406d027f3	MARCO	12261811645	NULL	12261811645	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	9ffbbf7340bbd65e9e3baa9406d027f3	MARCO	12261811645	NULL	12261811645	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	9ffbbf7340bbd65e9e3baa9406d027f3	MARCO	12261811645	NULL	12261811645	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	9ffbbf7340bbd65e9e3baa9406d027f3	MARCO	12261811645	NULL	12261811645	01611	CLORETO DE POTASSIO 600 MG CA VO UN	0.0000	0.4867	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	9ffbbf7340bbd65e9e3baa9406d027f3	MARCO	12261811645	NULL	12261811645	01611	CLORETO DE POTASSIO 600 MG CA VO UN	0.0000	0.4867	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	9ffbbf7340bbd65e9e3baa9406d027f3	MARCO	12261811645	NULL	12261811645	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.0000	0.8078	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	9ffbbf7340bbd65e9e3baa9406d027f3	MARCO	12261811645	NULL	12261811645	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.0000	0.8078	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	9ffbbf7340bbd65e9e3baa9406d027f3	MARCO	12261811645	NULL	12261811645	51208	SORO RINGER SIMPLES 500 ML SI IV BS	0.0000	5.9400	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	9ffbbf7340bbd65e9e3baa9406d027f3	MARCO	12261811645	NULL	12261811645	51208	SORO RINGER SIMPLES 500 ML SI IV BS	0.0000	5.9400	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	9ffbbf7340bbd65e9e3baa9406d027f3	MARCO	12261811645	NULL	12261811645	51208	SORO RINGER SIMPLES 500 ML SI IV BS	0.0000	11.8800	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	9ffbbf7340bbd65e9e3baa9406d027f3	MARCO	12261811645	NULL	12261811645	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1773	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	9ffbbf7340bbd65e9e3baa9406d027f3	MARCO	12261811645	NULL	12261811645	00090	SERINGA DESC 20 ML UN	0.0000	0.5376	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	9ffbbf7340bbd65e9e3baa9406d027f3	MARCO	12261811645	NULL	12261811645	00090	SERINGA DESC 20 ML UN	0.0000	0.5376	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	9ffbbf7340bbd65e9e3baa9406d027f3	MARCO	12261811645	NULL	12261811645	00090	SERINGA DESC 20 ML UN	0.0000	0.5376	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	9ffbbf7340bbd65e9e3baa9406d027f3	MARCO	12261811645	NULL	12261811645	00090	SERINGA DESC 20 ML UN	0.0000	0.5376	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4094	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4094	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4094	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	01496	FENITOINA 50 MG/ML 5 ML SI IM IV AP	0.0000	2.3400	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	01496	FENITOINA 50 MG/ML 5 ML SI IM IV AP	0.0000	2.3400	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	01496	FENITOINA 50 MG/ML 5 ML SI IM IV AP	0.0000	2.3400	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	02246	HIDROCORTISONA 100 MG PO IM IV FA	0.0000	2.8300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	26981	SORO FISIOLOGICO 0,9% 10 ML SI IV AP	0.0000	0.4800	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	26981	SORO FISIOLOGICO 0,9% 10 ML SI IV AP	0.0000	0.4800	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	26981	SORO FISIOLOGICO 0,9% 10 ML SI IV AP	0.0000	0.4800	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	26981	SORO FISIOLOGICO 0,9% 10 ML SI IV AP	0.0000	0.9600	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	26981	SORO FISIOLOGICO 0,9% 10 ML SI IV AP	0.0000	0.9600	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	26981	SORO FISIOLOGICO 0,9% 10 ML SI IV AP	0.0000	0.9600	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	09070	ACETILCISTEINA 600MG PO VO SA	0.0000	3.5000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	09070	ACETILCISTEINA 600MG PO VO SA	0.0000	3.4950	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	09070	ACETILCISTEINA 600MG PO VO SA	0.0000	3.4950	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	09070	ACETILCISTEINA 600MG PO VO SA	0.0000	3.5000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	00091	SERINGA DESC 01 ML (INSULINA) UN	0.0000	0.3000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	15f461c0ca379f375bd9f8b18fbb101a	ANA	12753753845	NULL	12753753845	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR APRESENTADO A MAIOR	1705
Glosa Min	2018-10-03 00:00:00.000000	1084117	15f461c0ca379f375bd9f8b18fbb101a	ANA	12753753845	NULL	12753753845	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR APRESENTADO A MAIOR	1705
Glosa Min	2018-10-03 00:00:00.000000	1084117	15f461c0ca379f375bd9f8b18fbb101a	ANA	12753753845	NULL	12753753845	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR APRESENTADO A MAIOR	1705
Glosa Min	2018-10-03 00:00:00.000000	1084117	15f461c0ca379f375bd9f8b18fbb101a	ANA	12753753845	NULL	12753753845	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.0000	0.4000	NULL	VALOR APRESENTADO A MAIOR	1705
Glosa Min	2018-10-03 00:00:00.000000	1084117	15f461c0ca379f375bd9f8b18fbb101a	ANA	12753753845	NULL	12753753845	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1800	NULL	VALOR APRESENTADO A MAIOR	1705
Glosa Min	2018-10-03 00:00:00.000000	1084117	15f461c0ca379f375bd9f8b18fbb101a	ANA	12753753845	NULL	12753753845	52963	FILTRO DE LEUCOCITOS	0.0000	2.8829	NULL	COBRANCA DE HONORARIOS EM DUPLICIDADE	2607
Glosa Min	2018-10-03 00:00:00.000000	1084117	15f461c0ca379f375bd9f8b18fbb101a	ANA	12753753845	NULL	12753753845	00657	CEFAZOLINA 1 GR + DIL. 10 ML PO IM IV FA	0.0000	8.1300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00124	LUVA CIRURGICA UN	0.0000	1.4475	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00124	LUVA CIRURGICA UN	0.0000	1.4475	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00124	LUVA CIRURGICA UN	0.0000	1.4500	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4072	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4072	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4072	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4072	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4072	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4072	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4072	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4072	NULL	COBRANCA DE MEDICAMENTO EM QUANTIDADE INCOMPATIVEL COM A PERMANENCIA	2107
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4072	NULL	VALOR APRESENTADO A MAIOR	1705
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4072	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	01611	CLORETO DE POTASSIO 600 MG CA VO UN	0.0000	0.4870	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	01611	CLORETO DE POTASSIO 600 MG CA VO UN	0.0000	0.4870	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	01611	CLORETO DE POTASSIO 600 MG CA VO UN	0.0000	0.4870	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00184	CLORETO DE POTASSIO 10% 10 ML SI IV AP	0.0000	0.5900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	02197	METAMUCIL (PLANTAGO OVATA) 3,4 G PO VO EV	0.0000	2.4600	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	02355	AMOXICILINA 1 G + CLAVULANATO 200 MG + DIL. 10 ML	0.0000	36.4667	NULL	COBRANCA DE MEDICAMENTO EM QUANTIDADE INCOMPATIVEL COM A PERMANENCIA	2107
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	02355	AMOXICILINA 1 G + CLAVULANATO 200 MG + DIL. 10 ML	0.0000	36.4667	NULL	COBRANCA DE MEDICAMENTO EM QUANTIDADE INCOMPATIVEL COM A PERMANENCIA	2107
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	02355	AMOXICILINA 1 G + CLAVULANATO 200 MG + DIL. 10 ML	0.0000	36.4667	NULL	COBRANCA DE MEDICAMENTO EM QUANTIDADE INCOMPATIVEL COM A PERMANENCIA	2107
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00090	SERINGA DESC 20 ML UN	0.0000	0.5357	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00090	SERINGA DESC 20 ML UN	0.0000	0.5367	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00090	SERINGA DESC 20 ML UN	0.0000	0.5367	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00090	SERINGA DESC 20 ML UN	0.0000	0.5367	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00090	SERINGA DESC 20 ML UN	0.0000	0.5367	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00090	SERINGA DESC 20 ML UN	0.0000	0.5367	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00090	SERINGA DESC 20 ML UN	0.0000	0.5367	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00090	SERINGA DESC 20 ML UN	0.0000	1.0733	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	2e6b6f291f2df9beb1fbda6028678909	ANNA	12463693448	NULL	12463693448	00184	CLORETO DE POTASSIO 10% 10 ML SI IV AP	0.0000	0.3000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	2e6b6f291f2df9beb1fbda6028678909	ANNA	12463693448	NULL	12463693448	25040014	Fisioterapia Respiratória - em Doente Clínico Internado	0.0000	5.0300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	2e6b6f291f2df9beb1fbda6028678909	ANNA	12463693448	NULL	12463693448	25040014	Fisioterapia Respiratória - em Doente Clínico Internado	0.0000	5.0300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	2e6b6f291f2df9beb1fbda6028678909	ANNA	12463693448	NULL	12463693448	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1800	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	2e6b6f291f2df9beb1fbda6028678909	ANNA	12463693448	NULL	12463693448	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1800	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	2e6b6f291f2df9beb1fbda6028678909	ANNA	12463693448	NULL	12463693448	51241	AGULHA 123X45	0.0000	0.1900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	2e6b6f291f2df9beb1fbda6028678909	ANNA	12463693448	NULL	12463693448	09070	ACETILCISTEINA 600MG PO VO SA	0.0000	3.5000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	2e6b6f291f2df9beb1fbda6028678909	ANNA	12463693448	NULL	12463693448	09070	ACETILCISTEINA 600MG PO VO SA	0.0000	3.5000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	31d18d6607d9e742c53e748d6a55d740	CARLOS	12557779343	NULL	12557779343	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00124	LUVA CIRURGICA UN	0.0000	1.4478	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00124	LUVA CIRURGICA UN	0.0000	1.4500	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00124	LUVA CIRURGICA UN	0.0000	1.4478	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.0000	0.6867	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.0000	0.6871	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.0000	0.6871	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.0000	0.6871	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	35382	COMPRESSAS DE GASES 7.5 X7,5 (11 FIOS ESTERIL) UN	0.0000	0.6000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00487	RANITIDINA 25 MG/ML 2 ML SI IM IV AP	0.0000	0.9300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00487	RANITIDINA 25 MG/ML 2 ML SI IM IV AP	0.0000	0.9300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.0000	0.4000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.0000	0.4000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.0000	0.4000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.0000	1.6200	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1776	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1776	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	51649	ALCOOL ETILICO 70 % ST TP ML	0.0000	0.0300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	54157	EQUIPO P/ DIETA ENTERAL UN	0.0000	1.7000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00090	SERINGA DESC 20 ML UN	0.0000	0.5375	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00090	SERINGA DESC 20 ML UN	0.0000	0.5375	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00090	SERINGA DESC 20 ML UN	0.0000	0.5400	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00090	SERINGA DESC 20 ML UN	0.0000	1.6100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1965b0cdebe9017c3397c8641147759	JOSE	12705413746	NULL	12705413746	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1965b0cdebe9017c3397c8641147759	JOSE	12705413746	NULL	12705413746	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.0000	0.6900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1965b0cdebe9017c3397c8641147759	JOSE	12705413746	NULL	12705413746	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.0000	0.8074	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1965b0cdebe9017c3397c8641147759	JOSE	12705413746	NULL	12705413746	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.0000	0.8074	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1965b0cdebe9017c3397c8641147759	JOSE	12705413746	NULL	12705413746	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.0000	0.8074	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1965b0cdebe9017c3397c8641147759	JOSE	12705413746	NULL	12705413746	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.0000	0.8074	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1965b0cdebe9017c3397c8641147759	JOSE	12705413746	NULL	12705413746	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.0000	0.8074	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1965b0cdebe9017c3397c8641147759	JOSE	12705413746	NULL	12705413746	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1775	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1965b0cdebe9017c3397c8641147759	JOSE	12705413746	NULL	12705413746	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1775	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1965b0cdebe9017c3397c8641147759	JOSE	12705413746	NULL	12705413746	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1775	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1965b0cdebe9017c3397c8641147759	JOSE	12705413746	NULL	12705413746	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1775	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1965b0cdebe9017c3397c8641147759	JOSE	12705413746	NULL	12705413746	51671	REPARIL (ESCINA + DIETILAMONIO) GL TP GR	0.0000	0.0000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1965b0cdebe9017c3397c8641147759	JOSE	12705413746	NULL	12705413746	00090	SERINGA DESC 20 ML UN	0.0000	0.5375	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1965b0cdebe9017c3397c8641147759	JOSE	12705413746	NULL	12705413746	00090	SERINGA DESC 20 ML UN	0.0000	0.5375	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1965b0cdebe9017c3397c8641147759	JOSE	12705413746	NULL	12705413746	00090	SERINGA DESC 20 ML UN	0.0000	0.5375	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1965b0cdebe9017c3397c8641147759	JOSE	12705413746	NULL	12705413746	00090	SERINGA DESC 20 ML UN	0.0000	0.5375	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1965b0cdebe9017c3397c8641147759	JOSE	12705413746	NULL	12705413746	00090	SERINGA DESC 20 ML UN	0.0000	0.5375	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1965b0cdebe9017c3397c8641147759	JOSE	12705413746	NULL	12705413746	00090	SERINGA DESC 20 ML UN	0.0000	0.5375	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1965b0cdebe9017c3397c8641147759	JOSE	12705413746	NULL	12705413746	00090	SERINGA DESC 20 ML UN	0.0000	0.5375	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1965b0cdebe9017c3397c8641147759	JOSE	12705413746	NULL	12705413746	00090	SERINGA DESC 20 ML UN	0.0000	0.5375	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1965b0cdebe9017c3397c8641147759	JOSE	12705413746	NULL	12705413746	00098	ABOCATH N 14 A 22 UN	0.0000	3.7700	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	dd6f8d6c53ffe9bfd3aa9590ba500cc8	ILDA	12751932542	NULL	12751932542	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	13.6200	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	dd6f8d6c53ffe9bfd3aa9590ba500cc8	ILDA	12751932542	NULL	12751932542	00172	SORO FISIOLOGICO 0,9% 500 ML SI IV BS	0.0000	14.2000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	dd6f8d6c53ffe9bfd3aa9590ba500cc8	ILDA	12751932542	NULL	12751932542	55279	TRAMADOL 50 MG 1 ML SI IM IV AP	0.0000	12.5800	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	dd6f8d6c53ffe9bfd3aa9590ba500cc8	ILDA	12751932542	NULL	12751932542	00558	LAMINA BISTURI N 20, 22 E 24 UN	0.0000	0.6700	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a39fe8b0276da428395df4da4f2b1537	JOSE	12442708440	NULL	12442708440	00111	ABOCATH N 14 A 22 UN	0.0000	3.7700	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a39fe8b0276da428395df4da4f2b1537	JOSE	12442708440	NULL	12442708440	00128	LUVA DE PROCEDIMENTO UNIDADE UN	0.0000	1.6700	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a39fe8b0276da428395df4da4f2b1537	JOSE	12442708440	NULL	12442708440	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a39fe8b0276da428395df4da4f2b1537	JOSE	12442708440	NULL	12442708440	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a39fe8b0276da428395df4da4f2b1537	JOSE	12442708440	NULL	12442708440	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a39fe8b0276da428395df4da4f2b1537	JOSE	12442708440	NULL	12442708440	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a39fe8b0276da428395df4da4f2b1537	JOSE	12442708440	NULL	12442708440	01691	NISTATINA 100.000 UI/ML SU VO ML	0.0000	0.2950	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a39fe8b0276da428395df4da4f2b1537	JOSE	12442708440	NULL	12442708440	20691	HIDROCORTISONA 100 MG PO IM IV FA	0.0000	2.8300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a39fe8b0276da428395df4da4f2b1537	JOSE	12442708440	NULL	12442708440	20691	HIDROCORTISONA 100 MG PO IM IV FA	0.0000	2.8300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a39fe8b0276da428395df4da4f2b1537	JOSE	12442708440	NULL	12442708440	20691	HIDROCORTISONA 100 MG PO IM IV FA	0.0000	2.8300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a39fe8b0276da428395df4da4f2b1537	JOSE	12442708440	NULL	12442708440	20691	HIDROCORTISONA 100 MG PO IM IV FA	0.0000	2.8300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a39fe8b0276da428395df4da4f2b1537	JOSE	12442708440	NULL	12442708440	26981	SORO FISIOLOGICO 0,9% 10 ML SI IV AP	0.0000	0.1400	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a39fe8b0276da428395df4da4f2b1537	JOSE	12442708440	NULL	12442708440	26981	SORO FISIOLOGICO 0,9% 10 ML SI IV AP	0.0000	0.1400	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a39fe8b0276da428395df4da4f2b1537	JOSE	12442708440	NULL	12442708440	26981	SORO FISIOLOGICO 0,9% 10 ML SI IV AP	0.0000	0.1400	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a39fe8b0276da428395df4da4f2b1537	JOSE	12442708440	NULL	12442708440	29020166	Nebulização Simples com Broncodilatador	0.0000	1.1700	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a39fe8b0276da428395df4da4f2b1537	JOSE	12442708440	NULL	12442708440	29020166	Nebulização Simples com Broncodilatador	0.0000	4.6800	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a39fe8b0276da428395df4da4f2b1537	JOSE	12442708440	NULL	12442708440	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1765	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a39fe8b0276da428395df4da4f2b1537	JOSE	12442708440	NULL	12442708440	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1765	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a39fe8b0276da428395df4da4f2b1537	JOSE	12442708440	NULL	12442708440	51241	AGULHA 123X45	0.0000	0.1900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a39fe8b0276da428395df4da4f2b1537	JOSE	12442708440	NULL	12442708440	51241	AGULHA 123X45	0.0000	0.1900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a39fe8b0276da428395df4da4f2b1537	JOSE	12442708440	NULL	12442708440	00090	SERINGA DESC 20 ML UN	0.0000	0.5400	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a39fe8b0276da428395df4da4f2b1537	JOSE	12442708440	NULL	12442708440	00090	SERINGA DESC 20 ML UN	0.0000	0.5373	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a39fe8b0276da428395df4da4f2b1537	JOSE	12442708440	NULL	12442708440	00090	SERINGA DESC 20 ML UN	0.0000	0.5373	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a39fe8b0276da428395df4da4f2b1537	JOSE	12442708440	NULL	12442708440	00090	SERINGA DESC 20 ML UN	0.0000	0.5373	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a39fe8b0276da428395df4da4f2b1537	JOSE	12442708440	NULL	12442708440	00943	EQUIPO POLIFIX 2 VIAS UN	0.0000	2.5500	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	61e4786d45edfdbf19b77fb2c6ce6b9c	REINALDO	12754482747	NULL	12754482747	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	61e4786d45edfdbf19b77fb2c6ce6b9c	REINALDO	12754482747	NULL	12754482747	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	61e4786d45edfdbf19b77fb2c6ce6b9c	REINALDO	12754482747	NULL	12754482747	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	61e4786d45edfdbf19b77fb2c6ce6b9c	REINALDO	12754482747	NULL	12754482747	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	61e4786d45edfdbf19b77fb2c6ce6b9c	REINALDO	12754482747	NULL	12754482747	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	61e4786d45edfdbf19b77fb2c6ce6b9c	REINALDO	12754482747	NULL	12754482747	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	61e4786d45edfdbf19b77fb2c6ce6b9c	REINALDO	12754482747	NULL	12754482747	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.0000	0.6900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	61e4786d45edfdbf19b77fb2c6ce6b9c	REINALDO	12754482747	NULL	12754482747	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.0000	0.6900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	61e4786d45edfdbf19b77fb2c6ce6b9c	REINALDO	12754482747	NULL	12754482747	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.0000	0.6900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	61e4786d45edfdbf19b77fb2c6ce6b9c	REINALDO	12754482747	NULL	12754482747	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.0000	0.6900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	61e4786d45edfdbf19b77fb2c6ce6b9c	REINALDO	12754482747	NULL	12754482747	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.0000	0.6900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	61e4786d45edfdbf19b77fb2c6ce6b9c	REINALDO	12754482747	NULL	12754482747	00037	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.3800	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	61e4786d45edfdbf19b77fb2c6ce6b9c	REINALDO	12754482747	NULL	12754482747	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	61e4786d45edfdbf19b77fb2c6ce6b9c	REINALDO	12754482747	NULL	12754482747	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	61e4786d45edfdbf19b77fb2c6ce6b9c	REINALDO	12754482747	NULL	12754482747	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	61e4786d45edfdbf19b77fb2c6ce6b9c	REINALDO	12754482747	NULL	12754482747	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	102001	DIARIA DE APARTAMENTO	0.0000	288.8900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	102001	DIARIA DE APARTAMENTO	0.0000	288.8900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4072	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4072	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4072	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4072	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4072	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	00090	SERINGA DESC 20 ML UN	0.0000	0.5371	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	00090	SERINGA DESC 20 ML UN	0.0000	0.5371	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	00090	SERINGA DESC 20 ML UN	0.0000	0.5371	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	00090	SERINGA DESC 20 ML UN	0.0000	0.5371	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	00090	SERINGA DESC 20 ML UN	0.0000	0.5371	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	081fdadb830fb547e83c43fabdb88372	ELZA	12377335349	NULL	12377335349	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	081fdadb830fb547e83c43fabdb88372	ELZA	12377335349	NULL	12377335349	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	081fdadb830fb547e83c43fabdb88372	ELZA	12377335349	NULL	12377335349	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	081fdadb830fb547e83c43fabdb88372	ELZA	12377335349	NULL	12377335349	01611	CLORETO DE POTASSIO 600 MG CA VO UN	0.0000	0.4900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	081fdadb830fb547e83c43fabdb88372	ELZA	12377335349	NULL	12377335349	01611	CLORETO DE POTASSIO 600 MG CA VO UN	0.0000	0.4900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	081fdadb830fb547e83c43fabdb88372	ELZA	12377335349	NULL	12377335349	01611	CLORETO DE POTASSIO 600 MG CA VO UN	0.0000	0.4900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	081fdadb830fb547e83c43fabdb88372	ELZA	12377335349	NULL	12377335349	02246	HIDROCORTISONA 100 MG PO IM IV FA	0.0000	2.8300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	081fdadb830fb547e83c43fabdb88372	ELZA	12377335349	NULL	12377335349	02246	HIDROCORTISONA 100 MG PO IM IV FA	0.0000	5.6700	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.0000	0.6860	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1800	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	51379	SERINGA DESC 05 ML UN	0.0000	0.1900	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	51379	SERINGA DESC 05 ML UN	0.0000	0.1900	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	51379	SERINGA DESC 05 ML UN	0.0000	0.1900	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	51379	SERINGA DESC 05 ML UN	0.0000	0.1900	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	51379	SERINGA DESC 05 ML UN	0.0000	0.1900	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	51379	SERINGA DESC 05 ML UN	0.0000	0.1900	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	51379	SERINGA DESC 05 ML UN	0.0000	0.1900	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	51379	SERINGA DESC 05 ML UN	0.0000	0.1900	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	51379	SERINGA DESC 05 ML UN	0.0000	0.1900	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	51379	SERINGA DESC 05 ML UN	0.0000	0.1900	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	51379	SERINGA DESC 05 ML UN	0.0000	0.1900	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	345c226bfea274af1372d41b0305a6c8	ALTINO	12720257940	NULL	12720257940	04073	TRAMADOL 50 MG 1 ML SI IM IV AP	0.0000	4.1900	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	345c226bfea274af1372d41b0305a6c8	ALTINO	12720257940	NULL	12720257940	00493	BROMOPRIDA 5 MG/ML 2 ML SI IM IV AP	0.0000	0.0000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	345c226bfea274af1372d41b0305a6c8	ALTINO	12720257940	NULL	12720257940	00090	SERINGA DESC 20 ML UN	0.0000	0.5367	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	345c226bfea274af1372d41b0305a6c8	ALTINO	12720257940	NULL	12720257940	00090	SERINGA DESC 20 ML UN	0.0000	0.5367	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	dd486d36a88cfef0b44fe652638a0164	DELFINA	12660326244	NULL	12660326244	01062	CATETER OXIGENIO TIPO OCULOS UN	0.0000	1.0000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	dd486d36a88cfef0b44fe652638a0164	DELFINA	12660326244	NULL	12660326244	01062	CATETER OXIGENIO TIPO OCULOS UN	0.0000	1.0000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	dd486d36a88cfef0b44fe652638a0164	DELFINA	12660326244	NULL	12660326244	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	dd486d36a88cfef0b44fe652638a0164	DELFINA	12660326244	NULL	12660326244	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	dd486d36a88cfef0b44fe652638a0164	DELFINA	12660326244	NULL	12660326244	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	dd486d36a88cfef0b44fe652638a0164	DELFINA	12660326244	NULL	12660326244	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	dd486d36a88cfef0b44fe652638a0164	DELFINA	12660326244	NULL	12660326244	00090	SERINGA DESC 20 ML UN	0.0000	0.5400	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	dd486d36a88cfef0b44fe652638a0164	DELFINA	12660326244	NULL	12660326244	00090	SERINGA DESC 20 ML UN	0.0000	0.5400	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	01652	TRAMADOL 50 MG CP VO UN	0.0000	1.9300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.0000	0.6900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.0000	0.6875	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.0000	0.6900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.0000	0.6900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.0000	0.6900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.0000	0.6900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.0000	0.6900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.0000	0.6900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.0000	0.6900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	35382	COMPRESSAS DE GASES 7.5 X7,5 (11 FIOS ESTERIL) UN	0.0000	0.3000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	35382	COMPRESSAS DE GASES 7.5 X7,5 (11 FIOS ESTERIL) UN	0.0000	0.3000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	35382	COMPRESSAS DE GASES 7.5 X7,5 (11 FIOS ESTERIL) UN	0.0000	0.3000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1800	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1800	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1800	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3fb5c891f31bb9efcb05395066127c52	ALAIDE	12636273441	NULL	12636273441	26981	SORO FISIOLOGICO 0,9% 10 ML SI IV AP	0.0000	0.6000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	610c198ec4c064687cf0524f147d3aed	ROBERTO	12748814743	NULL	12748814743	16322	BENZILPENICILINA POTASSICA CRIST. 5.000.000	8.0700	8.0683	0.0017	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	51378	SERINGA DESC 03 ML UN	0.1500	0.0600	0.0900	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	54678	HUMULIN	0.2500	0.1000	0.1500	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00127	LUVA DE PROCEDIMENTO UNIDADE UN	0.3300	0.1300	0.2000	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.4000	0.1600	0.2400	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.4000	0.1600	0.2400	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.4000	0.1600	0.2400	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.4000	0.1600	0.2400	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.4000	0.1600	0.2400	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.4000	0.1600	0.2400	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.4000	0.1600	0.2400	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.4000	0.1600	0.2400	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.4000	0.1600	0.2400	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.4000	0.1600	0.2400	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	54687	IODOPOVIDONA SD TP ML	0.4000	0.1600	0.2400	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	14191	OMEPRAZOL 20 MG CA VO UN	0.4500	0.1800	0.2700	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00090	SERINGA DESC 20 ML UN	0.5400	0.2200	0.3200	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	07802	PIPERACILINA 4 G + TAZOBACTAM 500 MG PO IV FA	83.4500	32.5900	50.8600	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	07802	PIPERACILINA 4 G + TAZOBACTAM 500 MG PO IV FA	83.4500	32.5900	50.8600	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	01081197	edcdbaa61bbaa91565bc29f993979fda	JOHN	12767485129	NULL	12767485129	32020040	COLUNA DORSAL AP LATERAL	0.0000	24.0850	NULL	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	01081197	6d2e0c731641497ed5076fae7729f241	MARI	12763893222	NULL	12763893222	201001	TAXA DE SALA PORTE 0	NULL	0.0000	NULL	OPME INVALIDO	2201
Glosa Min	2018-10-03 00:00:00.000000	01081197	2f6e33ac8c03dabedfcad2337f7d3f03	LORIVAL	12661325027	NULL	12661325027	201001	TAXA DE SALA PORTE 0	NULL	0.0000	NULL	OPME INVALIDO	2201
Glosa Min	2018-10-03 00:00:00.000000	1084117	16b1e9f62f247f02ad5cac910ee15b4e	BERCHOLINA	12631612848	NULL	12631612848	55328	TRAMADOL 100 MG 2 ML SI IM IV AP	17.9800	17.1300	0.8500	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	16b1e9f62f247f02ad5cac910ee15b4e	BERCHOLINA	12631612848	NULL	12631612848	22421	PIPERACILINA 2 G + TAZOBACTAM 250 MG 30 ML PO IV	55.3400	52.7400	2.6000	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	01081197	71f5440171ef97870d290cb22b5aa301	ITAMAR	12750251527	NULL	12750251527	20010010	ECG - ELETROCARDIOGRAMA	0.0000	11.5710	NULL	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	01081195	6650c57ea7c065d5dbd2a475d4a9212d	JUCELINA	12816050014	NULL	12816050014	00010014	CONSULTA EM CONSULTORIO MEDICO	0.0000	50.0000	NULL	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12579183644	NULL	12579183644	32204	CLORETO DE SODIO 0,9% 10 ML SI IV AP	0.4800	0.0000	0.4800	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12579183644	NULL	12579183644	37761	ALCOOL ETILICO 70 % ST TP ML	0.0600	0.0300	0.0300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12579183644	NULL	12579183644	08648	ESPARADRAPO 10 X 4.5 CM CM	0.4000	0.2000	0.2000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12579183644	NULL	12579183644	32204	CLORETO DE SODIO 0,9% 10 ML SI IV AP	0.9600	0.0000	0.9600	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12579183644	NULL	12579183644	37761	ALCOOL ETILICO 70 % ST TP ML	0.0600	0.0300	0.0300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12579183644	NULL	12579183644	00485	AGUA BIDESTILADA 500 ML SI IM IV BS	6.4300	0.0000	6.4300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12579183644	NULL	12579183644	32204	CLORETO DE SODIO 0,9% 10 ML SI IV AP	0.9600	0.0000	0.9600	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12579183644	NULL	12579183644	00817	ALGODAO HIDROFILO BOLINHA UN	0.5100	0.2600	0.2500	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12579183644	NULL	12579183644	02720	BOLSA COLETORA (SISTEMA ABERTO) UN	1.2800	0.6400	0.6400	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12579183644	NULL	12579183644	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.3500	0.0000	0.3500	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	d17b3c5ae418d82694895a326dee545a	ODILIA	12670516743	NULL	12670516743	05975	COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER	0.0300	0.0000	0.0300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	d17b3c5ae418d82694895a326dee545a	ODILIA	12670516743	NULL	12670516743	30376	BROMETO DE IPRATROPIO 0,25MG/ML SL IN GT	0.6000	0.0000	0.6000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	d17b3c5ae418d82694895a326dee545a	ODILIA	12670516743	NULL	12670516743	08648	ESPARADRAPO 10 X 4.5 CM CM	0.4000	0.2000	0.2000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	20cbe2e07b1dcd2b6af609a50df7ae80	LUCELENA	12690767849	NULL	12690767849	33219	LUVA DE PROCEDIMENTO UNIDADE UN	1.0000	0.6700	0.3300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	20cbe2e07b1dcd2b6af609a50df7ae80	LUCELENA	12690767849	NULL	12690767849	33219	LUVA DE PROCEDIMENTO UNIDADE UN	1.0000	0.6700	0.3300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	20cbe2e07b1dcd2b6af609a50df7ae80	LUCELENA	12690767849	NULL	12690767849	00817	ALGODAO HIDROFILO BOLINHA UN	0.5100	0.1300	0.3800	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	20cbe2e07b1dcd2b6af609a50df7ae80	LUCELENA	12690767849	NULL	12690767849	00817	ALGODAO HIDROFILO BOLINHA UN	0.5100	0.2600	0.2500	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	20cbe2e07b1dcd2b6af609a50df7ae80	LUCELENA	12690767849	NULL	12690767849	37761	ALCOOL ETILICO 70 % ST TP ML	0.0600	0.0300	0.0300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	13757	IODOPOVIDONA SD TP ML	0.3000	0.2000	0.1000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	08648	ESPARADRAPO 10 X 4.5 CM CM	0.4000	0.0000	0.4000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	00817	ALGODAO HIDROFILO BOLINHA UN	0.5100	0.2600	0.2500	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	14370	FIO MONONYLON 3-0 C/ AGULHA 2,4 3/8 163T E	13.3700	6.6900	6.6800	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00817	ALGODAO HIDROFILO BOLINHA UN	0.2600	0.1300	0.1300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	37761	ALCOOL ETILICO 70 % ST TP ML	0.0300	0.0200	0.0100	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	19151	SERINGA DESC 10 ML UN	0.3300	0.0000	0.3300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	08648	ESPARADRAPO 10 X 4.5 CM CM	0.4000	0.2000	0.2000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	37761	ALCOOL ETILICO 70 % ST TP ML	0.0600	0.0300	0.0300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	02720	BOLSA COLETORA (SISTEMA ABERTO) UN	1.2800	0.6400	0.6400	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00817	ALGODAO HIDROFILO BOLINHA UN	0.5100	0.1300	0.3800	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	52353	ABAIXADOR DE LINGUA UN	0.0500	0.0300	0.0200	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00817	ALGODAO HIDROFILO BOLINHA UN	0.5100	0.2600	0.2500	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00817	ALGODAO HIDROFILO BOLINHA UN	0.5100	0.2600	0.2500	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	37761	ALCOOL ETILICO 70 % ST TP ML	0.0600	0.0300	0.0300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	752c651cb4fd049e19c685f87fbe8bdc	EDUARDO	12765990646	NULL	12765990646	37761	ALCOOL ETILICO 70 % ST TP ML	0.0600	0.0200	0.0400	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	752c651cb4fd049e19c685f87fbe8bdc	EDUARDO	12765990646	NULL	12765990646	37761	ALCOOL ETILICO 70 % ST TP ML	0.0600	0.0200	0.0400	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	05975	COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER	0.3000	0.0000	0.3000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	08648	ESPARADRAPO 10 X 4.5 CM CM	0.4000	0.2000	0.2000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	345c226bfea274af1372d41b0305a6c8	ALTINO	12720257940	NULL	12720257940	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.1000	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	345c226bfea274af1372d41b0305a6c8	ALTINO	12720257940	NULL	12720257940	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.1000	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	345c226bfea274af1372d41b0305a6c8	ALTINO	12720257940	NULL	12720257940	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.1000	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	345c226bfea274af1372d41b0305a6c8	ALTINO	12720257940	NULL	12720257940	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.1000	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	345c226bfea274af1372d41b0305a6c8	ALTINO	12720257940	NULL	12720257940	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.1000	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	345c226bfea274af1372d41b0305a6c8	ALTINO	12720257940	NULL	12720257940	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.1000	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	345c226bfea274af1372d41b0305a6c8	ALTINO	12720257940	NULL	12720257940	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1750	0.0050	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	345c226bfea274af1372d41b0305a6c8	ALTINO	12720257940	NULL	12720257940	07269	DIPIRONA 500 MG/ML 2 ML SI IV IM AP	0.6900	0.6860	0.0040	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	345c226bfea274af1372d41b0305a6c8	ALTINO	12720257940	NULL	12720257940	07269	DIPIRONA 500 MG/ML 2 ML SI IV IM AP	0.6900	0.6860	0.0040	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	345c226bfea274af1372d41b0305a6c8	ALTINO	12720257940	NULL	12720257940	13404	OMEPRAZOL 40 MG + DIL. 10 ML PO IV FA	19.5800	19.5750	0.0050	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	31d18d6607d9e742c53e748d6a55d740	CARLOS	12557779343	NULL	12557779343	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1760	0.0040	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	31d18d6607d9e742c53e748d6a55d740	CARLOS	12557779343	NULL	12557779343	07269	DIPIRONA 500 MG/ML 2 ML SI IV IM AP	0.6900	0.6860	0.0040	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	0405a686318e3fc262f105ed4be24d95	CARMELITA	12687161644	NULL	12687161644	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	5.1900	5.1800	0.0000	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	0405a686318e3fc262f105ed4be24d95	CARMELITA	12687161644	NULL	12687161644	19151	SERINGA DESC 10 ML UN	0.6700	0.6650	0.0050	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	0405a686318e3fc262f105ed4be24d95	CARMELITA	12687161644	NULL	12687161644	07269	DIPIRONA 500 MG/ML 2 ML SI IV IM AP	0.6900	0.6873	0.0027	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	0405a686318e3fc262f105ed4be24d95	CARMELITA	12687161644	NULL	12687161644	07269	DIPIRONA 500 MG/ML 2 ML SI IV IM AP	0.6900	0.6873	0.0027	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	0405a686318e3fc262f105ed4be24d95	CARMELITA	12687161644	NULL	12687161644	19160	SERINGA DESC 20 ML UN	0.5400	0.5367	0.0033	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	ea6abb4182a48f0934f3e9eb5affa056	DILVA	12697455440	NULL	12697455440	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1750	0.0050	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	ea6abb4182a48f0934f3e9eb5affa056	DILVA	12697455440	NULL	12697455440	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1750	0.0050	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	ea6abb4182a48f0934f3e9eb5affa056	DILVA	12697455440	NULL	12697455440	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1750	0.0050	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	ea6abb4182a48f0934f3e9eb5affa056	DILVA	12697455440	NULL	12697455440	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1750	0.0050	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	500e4b8f04552b423f9db8f81073659f	FIDELIS	12763450340	NULL	12763450340	00817	ALGODAO HIDROFILO BOLINHA UN	0.1300	0.1200	0.0000	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	500e4b8f04552b423f9db8f81073659f	FIDELIS	12763450340	NULL	12763450340	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1760	0.0040	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	27600	ONDANSETRONA 2 MG/ML 4 ML SI IM IV AP	13.5300	0.0000	13.5300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	27600	ONDANSETRONA 2 MG/ML 4 ML SI IM IV AP	13.5300	0.0000	13.5300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	11193	CLOREXIDINA 2 % ST TP ML	0.5300	0.0000	0.5300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	17310	IODOPOVIDONA ALCOOLICA SL TP ML	0.6000	0.0000	0.6000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	08435	EQUIPO P/ BOMBA DE INFUSAO ENTERAL / PARENT	20.2800	0.0000	20.2800	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	00817	ALGODAO HIDROFILO BOLINHA UN	0.5100	0.2600	0.2500	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	22748	LIDOCAINA 2% GE TP OU GR	2.5900	1.3000	1.2900	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	02720	BOLSA COLETORA (SISTEMA ABERTO) UN	1.2800	0.9600	0.3200	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	31d18d6607d9e742c53e748d6a55d740	CARLOS	12557779343	NULL	12557779343	07722	DRENO DE SUCÇAO UN	26.0000	0.0000	26.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	00817	ALGODAO HIDROFILO BOLINHA UN	0.2600	0.1300	0.1300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	33219	LUVA DE PROCEDIMENTO UNIDADE UN	1.0000	0.6700	0.3300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	00817	ALGODAO HIDROFILO BOLINHA UN	0.2600	0.1300	0.1300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	9ffbbf7340bbd65e9e3baa9406d027f3	MARCO	12261811645	NULL	12261811645	37761	ALCOOL ETILICO 70 % ST TP ML	0.0300	0.0200	0.0100	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	9ffbbf7340bbd65e9e3baa9406d027f3	MARCO	12261811645	NULL	12261811645	00817	ALGODAO HIDROFILO BOLINHA UN	0.2600	0.1300	0.1300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	9ffbbf7340bbd65e9e3baa9406d027f3	MARCO	12261811645	NULL	12261811645	33219	LUVA DE PROCEDIMENTO UNIDADE UN	1.0000	0.6700	0.3300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	9ffbbf7340bbd65e9e3baa9406d027f3	MARCO	12261811645	NULL	12261811645	30376	BROMETO DE IPRATROPIO 0,25MG/ML SL IN GT	0.1000	0.0000	0.1000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	5f044434edae42d3d17c4392018c7824	DINORA	12673932742	NULL	12673932742	32204	CLORETO DE SODIO 0,9% 10 ML SI IV AP	0.4800	0.0000	0.4800	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	5f044434edae42d3d17c4392018c7824	DINORA	12673932742	NULL	12673932742	00817	ALGODAO HIDROFILO BOLINHA UN	0.1300	0.0000	0.1300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	d4089ccef13567fd45b16fb0b60685fa	VERA	12656425943	NULL	12656425943	33219	LUVA DE PROCEDIMENTO UNIDADE UN	1.0000	0.0000	1.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	d4089ccef13567fd45b16fb0b60685fa	VERA	12656425943	NULL	12656425943	53660	EQUIPO MACRO-GOTAS FLEXIVEL C/ INJETOR LATE	1.5900	0.0000	1.5900	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	d4089ccef13567fd45b16fb0b60685fa	VERA	12656425943	NULL	12656425943	33219	LUVA DE PROCEDIMENTO UNIDADE UN	1.6700	0.6700	1.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	37761	ALCOOL ETILICO 70 % ST TP ML	0.0600	0.0300	0.0300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	27600	ONDANSETRONA 2 MG/ML 4 ML SI IM IV AP	13.5300	0.0000	13.5300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	57495	FILTRO BARREIRA E REGENERADOR DE CALOR E UM	24.0000	0.0000	24.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	27308	FIO MONOCRYL 5-0 C /AGULHA 1,65 45CM Y844G	44.2600	0.0000	44.2600	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	00817	ALGODAO HIDROFILO BOLINHA UN	0.5100	0.2600	0.2500	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	00817	ALGODAO HIDROFILO BOLINHA UN	0.5100	0.2600	0.2500	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	11134	HEPARINA 5000 UI/ML 5 ML SI IV SC ML	14.4000	0.0000	14.4000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	cd2840524be5a3f1d0939f241e24f32b	MARIA	12705908340	NULL	12705908340	33219	LUVA DE PROCEDIMENTO UNIDADE UN	1.0000	0.6700	0.3300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	cd2840524be5a3f1d0939f241e24f32b	MARIA	12705908340	NULL	12705908340	33219	LUVA DE PROCEDIMENTO UNIDADE UN	1.0000	0.6700	0.3300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	cd2840524be5a3f1d0939f241e24f32b	MARIA	12705908340	NULL	12705908340	33219	LUVA DE PROCEDIMENTO UNIDADE UN	1.0000	0.6700	0.3300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	cd2840524be5a3f1d0939f241e24f32b	MARIA	12705908340	NULL	12705908340	33219	LUVA DE PROCEDIMENTO UNIDADE UN	1.0000	0.6700	0.3300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	cd2840524be5a3f1d0939f241e24f32b	MARIA	12705908340	NULL	12705908340	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.0000	0.1800	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12603877940	NULL	12603877940	07269	DIPIRONA 500 MG/ML 2 ML SI IV IM AP	4.1200	3.4300	0.6900	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12603877940	NULL	12603877940	33227	LUVA CIRURGICA PAR UN	10.1300	5.7900	4.3400	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12603877940	NULL	12603877940	00817	ALGODAO HIDROFILO BOLINHA UN	0.2600	0.1300	0.1300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12603877940	NULL	12603877940	55018	ALGINATO DE CALCIO EM HIDROGEL GL TP GR	20.7000	13.8000	6.9000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12603877940	NULL	12603877940	28959	DERSANI LC TP ML	29.1000	19.4000	9.7000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12603877940	NULL	12603877940	37761	ALCOOL ETILICO 70 % ST TP ML	0.0300	0.0200	0.0100	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12603877940	NULL	12603877940	08664	ESPARADRAPO MICROPORE 50 X 10 CM CM	3.5800	2.5600	1.0200	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	37761	ALCOOL ETILICO 70 % ST TP ML	0.0300	0.0200	0.0100	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	4668d2494ed6c4b2d18be299efcb26a2	JOAO	12469689344	NULL	12469689344	25040014	ASSISTENCIA FISIATRICA RESPIRATORIA	0.0000	15.0800	NULL	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	818a6f2e549cc6a60aa20f9d0595eec9	ANTONIO	12565134343	NULL	12565134343	22896	CEFUROXIMA 750 MG + DIL. 6 ML PO IM IV FA	52.2500	52.2400	0.0000	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	818a6f2e549cc6a60aa20f9d0595eec9	ANTONIO	12565134343	NULL	12565134343	19160	SERINGA DESC 20 ML UN	0.5400	0.5371	0.0029	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	33219	LUVA DE PROCEDIMENTO UNIDADE UN	1.0000	0.6700	0.3300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	33219	LUVA DE PROCEDIMENTO UNIDADE UN	1.0000	0.6700	0.3300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	a050ed50115d2a6dd0b15b99b39063da	ARI	12676101147	NULL	12676101147	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4064	0.0036	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	a050ed50115d2a6dd0b15b99b39063da	ARI	12676101147	NULL	12676101147	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4067	0.0033	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	4ff3856efb5e71b547222c677fd1e9f1	DIVINO	12652092848	NULL	12652092848	33219	LUVA DE PROCEDIMENTO UNIDADE UN	1.6700	1.6600	0.0000	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	39df67956a358bf1eab89803158d25dd	HELENA	12655863342	NULL	12655863342	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1750	0.0050	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	39df67956a358bf1eab89803158d25dd	HELENA	12655863342	NULL	12655863342	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1750	0.0050	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	cb57fc8e673b7c8bc339e1fe25d70cd5	HELIO	12661165148	NULL	12661165148	07269	DIPIRONA 500 MG/ML 2 ML SI IV IM AP	0.6900	0.6866	0.0034	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	9d06dbe3a8516628c3a045963dfb9c42	INAN	12623574546	NULL	12623574546	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1757	0.0043	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	4668d2494ed6c4b2d18be299efcb26a2	JOAO	12469689344	NULL	12469689344	05975	COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER	0.3000	0.0000	0.3000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	53660	EQUIPO MACRO-GOTAS FLEXIVEL C/ INJETOR LATE	4.7700	1.5900	3.1800	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	01081197	5b1e846d62341272eec7cc65f2fed2e7	ANGELIA	12734666120	NULL	12734666120	20010010	ECG - ELETROCARDIOGRAMA	0.0000	11.5710	NULL	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	01081197	2bf69eac10c578157e3a3b03e18eccde	DIRCE	12676225126	NULL	12676225126	32050054	RX - RADIOGRAFIA DE TORAX - PA E PERFIL	0.0000	14.1474	NULL	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	8a5ecfde671848d05ac757e0112e689c	TEREZINHA	12700337042	NULL	12700337042	25040014	ASSISTENCIA FISIATRICA RESPIRATORIA	0.0000	20.1100	NULL	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	eecb3d883747b059c3fe231c34567476	AFFRIDES	12693180144	NULL	12693180144	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1770	0.0030	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	eecb3d883747b059c3fe231c34567476	AFFRIDES	12693180144	NULL	12693180144	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1770	0.0030	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	eecb3d883747b059c3fe231c34567476	AFFRIDES	12693180144	NULL	12693180144	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1770	0.0030	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	eecb3d883747b059c3fe231c34567476	AFFRIDES	12693180144	NULL	12693180144	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1770	0.0030	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	eecb3d883747b059c3fe231c34567476	AFFRIDES	12693180144	NULL	12693180144	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1770	0.0030	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	eecb3d883747b059c3fe231c34567476	AFFRIDES	12693180144	NULL	12693180144	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1770	0.0030	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	eecb3d883747b059c3fe231c34567476	AFFRIDES	12693180144	NULL	12693180144	00426	AGUA BIDESTILADA 10 ML SI IV IM AP	0.8100	0.8072	0.0028	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	eecb3d883747b059c3fe231c34567476	AFFRIDES	12693180144	NULL	12693180144	09733	ACETILCISTEINA 600MG PO VO SA	3.5000	3.4955	0.0045	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	eecb3d883747b059c3fe231c34567476	AFFRIDES	12693180144	NULL	12693180144	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4074	0.0026	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	08664	ESPARADRAPO MICROPORE 50 X 10 CM CM	0.2600	0.2561	0.0039	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	20672	SORO RINGER SIMPLES 500 ML SI IV BS	5.9400	5.9367	0.0033	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	20672	SORO RINGER SIMPLES 500 ML SI IV BS	5.9400	5.9367	0.0033	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	58661	ENCRISE (ARGIPRESSINA) 20 U/ML 1 ML SI SC	20.1200	20.1171	0.0029	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	22896	CEFUROXIMA 750 MG + DIL. 6 ML PO IM IV FA	26.1300	26.1271	0.0029	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4078	0.0022	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4078	0.0022	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4078	0.0022	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4078	0.0022	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4078	0.0022	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4078	0.0022	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	33227	LUVA CIRURGICA PAR UN	1.4500	1.4476	0.0024	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	33227	LUVA CIRURGICA PAR UN	1.4500	1.4476	0.0024	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	33227	LUVA CIRURGICA PAR UN	1.4500	1.4476	0.0024	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.1038	-0.0038	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	b288bbcfb9aecab51bcb0dba62ca0059	IVONETE	12743730847	NULL	12743730847	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4067	0.0033	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	b288bbcfb9aecab51bcb0dba62ca0059	IVONETE	12743730847	NULL	12743730847	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4067	0.0033	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	b288bbcfb9aecab51bcb0dba62ca0059	IVONETE	12743730847	NULL	12743730847	19160	SERINGA DESC 20 ML UN	0.5400	0.5359	0.0041	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	b288bbcfb9aecab51bcb0dba62ca0059	IVONETE	12743730847	NULL	12743730847	19160	SERINGA DESC 20 ML UN	0.5400	0.5367	0.0033	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	b288bbcfb9aecab51bcb0dba62ca0059	IVONETE	12743730847	NULL	12743730847	19160	SERINGA DESC 20 ML UN	0.5400	0.5367	0.0033	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1900	0.1900	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1800	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	00817	ALGODAO HIDROFILO BOLINHA UN	0.1000	0.0000	0.1000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4084	0.0016	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4084	0.0016	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4084	0.0016	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4084	0.0016	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4084	0.0016	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.1036	-0.0036	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.1036	-0.0036	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.1036	-0.0036	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	62aae4e8542779ba735279cbf8749d41	LAENE	12728266347	NULL	12728266347	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4000	0.0000	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	32204	CLORETO DE SODIO 0,9% 10 ML SI IV AP	0.4800	0.0000	0.4800	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	32204	CLORETO DE SODIO 0,9% 10 ML SI IV AP	0.4800	0.4800	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	32204	CLORETO DE SODIO 0,9% 10 ML SI IV AP	0.4800	0.4800	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	00426	AGUA BIDESTILADA 10 ML SI IV IM AP	0.8100	0.8067	0.0033	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	00426	AGUA BIDESTILADA 10 ML SI IV IM AP	0.8100	0.8067	0.0033	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	00426	AGUA BIDESTILADA 10 ML SI IV IM AP	0.8100	0.8067	0.0033	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	00426	AGUA BIDESTILADA 10 ML SI IV IM AP	0.8100	0.8067	0.0033	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	00426	AGUA BIDESTILADA 10 ML SI IV IM AP	0.8100	0.8067	0.0033	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	00426	AGUA BIDESTILADA 10 ML SI IV IM AP	0.8100	0.8067	0.0033	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	00426	AGUA BIDESTILADA 10 ML SI IV IM AP	0.8100	0.8067	0.0033	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	00426	AGUA BIDESTILADA 10 ML SI IV IM AP	0.8100	0.8067	0.0033	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	00426	AGUA BIDESTILADA 10 ML SI IV IM AP	0.8100	0.8067	0.0033	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	00426	AGUA BIDESTILADA 10 ML SI IV IM AP	0.8100	0.8067	0.0033	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	32204	CLORETO DE SODIO 0,9% 10 ML SI IV AP	0.4800	0.4800	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00426	AGUA BIDESTILADA 10 ML SI IV IM AP	0.4000	0.0000	0.4000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00426	AGUA BIDESTILADA 10 ML SI IV IM AP	0.8100	0.4040	0.4060	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	32204	CLORETO DE SODIO 0,9% 10 ML SI IV AP	0.9600	0.0000	0.9600	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	32204	CLORETO DE SODIO 0,9% 10 ML SI IV AP	0.9600	0.0000	0.9600	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	30376	BROMETO DE IPRATROPIO 0,25MG/ML SL IN GT	0.8000	0.0000	0.8000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	32204	CLORETO DE SODIO 0,9% 10 ML SI IV AP	0.4800	0.0000	0.4800	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	00485	AGUA BIDESTILADA 500 ML SI IM IV BS	6.4300	6.4200	0.0000	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	05975	COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER	0.3000	0.3833	-0.0833	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	05975	COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER	0.3000	0.3834	-0.0834	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	05975	COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER	0.3000	0.3833	-0.0833	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	19119	SERINGA DESC 01 ML (INSULINA) UN	0.3100	0.3050	0.0050	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	33537	PIPERACILINA 2 G + TAZOBACTAM 250 MG 30 ML	55.3400	55.3375	0.0025	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	33537	PIPERACILINA 2 G + TAZOBACTAM 250 MG 30 ML	55.3400	55.3375	0.0025	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	33537	PIPERACILINA 2 G + TAZOBACTAM 250 MG 30 ML	55.3400	55.3375	0.0025	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	33537	PIPERACILINA 2 G + TAZOBACTAM 250 MG 30 ML	55.3400	55.3375	0.0025	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	33537	PIPERACILINA 2 G + TAZOBACTAM 250 MG 30 ML	55.3400	55.3375	0.0025	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	42358	FUROSEMIDA 10 MG/ML 2 ML SI IM IV AP	1.2000	1.1964	0.0036	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4061	0.0039	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4061	0.0039	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4061	0.0039	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4061	0.0039	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	33227	LUVA CIRURGICA PAR UN	1.4500	1.4477	0.0023	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	33227	LUVA CIRURGICA PAR UN	1.4500	1.4477	0.0023	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	33227	LUVA CIRURGICA PAR UN	1.4500	1.4477	0.0023	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	33227	LUVA CIRURGICA PAR UN	1.4500	1.4477	0.0023	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	33227	LUVA CIRURGICA PAR UN	1.4500	1.4477	0.0023	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	33227	LUVA CIRURGICA PAR UN	1.4500	1.4477	0.0023	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	19135	SERINGA DESC 03 ML UN	0.1500	0.0000	0.1500	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	19135	SERINGA DESC 03 ML UN	0.3000	0.3000	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	19151	SERINGA DESC 10 ML UN	0.6700	0.6657	0.0043	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.2100	0.2057	0.0043	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.2100	0.2057	0.0043	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1772	0.0028	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1772	0.0028	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	cd2840524be5a3f1d0939f241e24f32b	MARIA	12705908340	NULL	12705908340	32204	CLORETO DE SODIO 0,9% 10 ML SI IV AP	0.4800	0.0000	0.4800	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	cd2840524be5a3f1d0939f241e24f32b	MARIA	12705908340	NULL	12705908340	32204	CLORETO DE SODIO 0,9% 10 ML SI IV AP	0.4800	0.0000	0.4800	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	cd2840524be5a3f1d0939f241e24f32b	MARIA	12705908340	NULL	12705908340	32204	CLORETO DE SODIO 0,9% 10 ML SI IV AP	0.4800	0.4800	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	cd2840524be5a3f1d0939f241e24f32b	MARIA	12705908340	NULL	12705908340	32204	CLORETO DE SODIO 0,9% 10 ML SI IV AP	0.4800	0.4800	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	cd2840524be5a3f1d0939f241e24f32b	MARIA	12705908340	NULL	12705908340	32204	CLORETO DE SODIO 0,9% 10 ML SI IV AP	0.4800	0.4800	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	cd2840524be5a3f1d0939f241e24f32b	MARIA	12705908340	NULL	12705908340	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1764	0.0036	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	cd2840524be5a3f1d0939f241e24f32b	MARIA	12705908340	NULL	12705908340	02461	FENOTEROL 2 MG/ML 10 ML AE IN DS	0.4300	0.0000	0.4300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	d17b3c5ae418d82694895a326dee545a	ODILIA	12670516743	NULL	12670516743	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1774	0.0026	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1766	0.0034	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1766	0.0034	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1766	0.0034	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1766	0.0034	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00426	AGUA BIDESTILADA 10 ML SI IV IM AP	1.6200	1.6154	0.0046	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	8a5ecfde671848d05ac757e0112e689c	TEREZINHA	12700337042	NULL	12700337042	19518	SOLUÇAO DE GLICERINA 12% 500 ML SL VR FR	8.8600	8.8500	0.0000	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	8a5ecfde671848d05ac757e0112e689c	TEREZINHA	12700337042	NULL	12700337042	10626	GLICOSE 50% 10 ML SI IV AP	2.7400	2.7350	0.0050	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	8a5ecfde671848d05ac757e0112e689c	TEREZINHA	12700337042	NULL	12700337042	09733	ACETILCISTEINA 600MG PO VO SA	3.5000	3.4965	0.0035	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	8a5ecfde671848d05ac757e0112e689c	TEREZINHA	12700337042	NULL	12700337042	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4071	0.0029	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	8a5ecfde671848d05ac757e0112e689c	TEREZINHA	12700337042	NULL	12700337042	19160	SERINGA DESC 20 ML UN	0.5400	0.5376	0.0024	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	8a5ecfde671848d05ac757e0112e689c	TEREZINHA	12700337042	NULL	12700337042	19160	SERINGA DESC 20 ML UN	0.5400	0.5376	0.0024	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	8a5ecfde671848d05ac757e0112e689c	TEREZINHA	12700337042	NULL	12700337042	19160	SERINGA DESC 20 ML UN	0.5400	0.5376	0.0024	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	8a5ecfde671848d05ac757e0112e689c	TEREZINHA	12700337042	NULL	12700337042	19160	SERINGA DESC 20 ML UN	0.5400	0.5376	0.0024	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	8a5ecfde671848d05ac757e0112e689c	TEREZINHA	12700337042	NULL	12700337042	19160	SERINGA DESC 20 ML UN	0.5400	0.5376	0.0024	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	70cf23c63f890f0b61da2542c3e13a09	TIAGO	12741864645	NULL	12741864645	07269	DIPIRONA 500 MG/ML 2 ML SI IV IM AP	1.3700	1.3600	0.0000	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	70cf23c63f890f0b61da2542c3e13a09	TIAGO	12741864645	NULL	12741864645	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1766	0.0034	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	70cf23c63f890f0b61da2542c3e13a09	TIAGO	12741864645	NULL	12741864645	19160	SERINGA DESC 20 ML UN	0.5400	0.5367	0.0033	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	70cf23c63f890f0b61da2542c3e13a09	TIAGO	12741864645	NULL	12741864645	19160	SERINGA DESC 20 ML UN	0.5400	0.5367	0.0033	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	0111beed375944f60c7ad4a7fd4874f8	WALDIR	12746025744	NULL	12746025744	00426	AGUA BIDESTILADA 10 ML SI IV IM AP	0.8100	0.8074	0.0026	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	0111beed375944f60c7ad4a7fd4874f8	WALDIR	12746025744	NULL	12746025744	00426	AGUA BIDESTILADA 10 ML SI IV IM AP	1.6200	1.6147	0.0053	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	0111beed375944f60c7ad4a7fd4874f8	WALDIR	12746025744	NULL	12746025744	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4068	0.0032	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	0111beed375944f60c7ad4a7fd4874f8	WALDIR	12746025744	NULL	12746025744	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4076	0.0024	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	0111beed375944f60c7ad4a7fd4874f8	WALDIR	12746025744	NULL	12746025744	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4076	0.0024	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	0111beed375944f60c7ad4a7fd4874f8	WALDIR	12746025744	NULL	12746025744	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4076	0.0024	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	0111beed375944f60c7ad4a7fd4874f8	WALDIR	12746025744	NULL	12746025744	19160	SERINGA DESC 20 ML UN	0.5400	0.5379	0.0021	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	52353	ABAIXADOR DE LINGUA UN	0.0500	0.0267	0.0233	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	00817	ALGODAO HIDROFILO BOLINHA UN	0.1300	0.0000	0.1300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	00817	ALGODAO HIDROFILO BOLINHA UN	0.5100	0.2600	0.2500	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	00035	ABOCATH (CATETER INTRAVENOSO) N. 14 A 22 UN	7.5300	7.5300	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	37761	ALCOOL ETILICO 70 % ST TP ML	0.0600	0.0300	0.0300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	27596	TIRA TESTE PARA GLICOSE UN	1.0400	1.0400	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	05975	COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER	0.3000	0.0000	0.3000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	05975	COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER	0.3000	0.3000	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	05975	COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER	0.3000	0.3000	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	05975	COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER	0.3000	0.0000	0.3000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	05975	COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER	0.3000	0.0000	0.3000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12647284040	NULL	12647284040	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4086	0.0014	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12662414945	NULL	12662414945	33219	LUVA DE PROCEDIMENTO UNIDADE UN	0.6700	0.6657	0.0043	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12662414945	NULL	12662414945	33219	LUVA DE PROCEDIMENTO UNIDADE UN	1.6700	1.6643	0.0057	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12662414945	NULL	12662414945	33219	LUVA DE PROCEDIMENTO UNIDADE UN	1.6700	1.6643	0.0057	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12662414945	NULL	12662414945	19160	SERINGA DESC 20 ML UN	0.5400	0.5367	0.0033	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12662414945	NULL	12662414945	13404	OMEPRAZOL 40 MG + DIL. 10 ML PO IV FA	19.5800	19.5750	0.0050	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12662414945	NULL	12662414945	19445	CLORETO DE POTASSIO 600 MG CA VO UN	0.4900	0.4867	0.0033	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12662414945	NULL	12662414945	19445	CLORETO DE POTASSIO 600 MG CA VO UN	0.4900	0.4867	0.0033	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12662414945	NULL	12662414945	19445	CLORETO DE POTASSIO 600 MG CA VO UN	0.4900	0.4867	0.0033	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12662414945	NULL	12662414945	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4071	0.0029	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12662414945	NULL	12662414945	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4071	0.0029	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12579183644	NULL	12579183644	05975	COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER	0.3000	0.1500	0.1500	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12579183644	NULL	12579183644	33227	LUVA CIRURGICA PAR UN	1.4500	1.4476	0.0024	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12579183644	NULL	12579183644	33227	LUVA CIRURGICA PAR UN	1.4500	1.4476	0.0024	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12579183644	NULL	12579183644	33227	LUVA CIRURGICA PAR UN	1.4500	1.4476	0.0024	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1770	0.0030	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1770	0.0030	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1770	0.0030	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1770	0.0030	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	11700	EQUIPO P/ BOMBA DE INFUSAO ENTERAL / PARENTERAL	NULL	0.0000	NULL	OPME INVALIDO	2201
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	11700	EQUIPO P/ BOMBA DE INFUSAO ENTERAL / PARENTERAL	NULL	0.0000	NULL	OPME INVALIDO	2201
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	34789	SONDA ASPIRAÇAO C/ VALVULA - TODAS - UTI UN	0.9400	0.9367	0.0033	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	25739	ELETRODO DESCARTAVEL (UTI) UN	18.4500	4.6100	13.8400	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00426	AGUA BIDESTILADA 10 ML SI IV IM AP	0.8100	0.0000	0.8100	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	37761	ALCOOL ETILICO 70 % ST TP ML	0.0600	0.0200	0.0400	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	33219	LUVA DE PROCEDIMENTO UNIDADE UN	0.6700	0.0000	0.6700	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00817	ALGODAO HIDROFILO BOLINHA UN	0.2600	0.1300	0.1300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	19151	SERINGA DESC 10 ML UN	0.3300	0.0000	0.3300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.2120	-0.1120	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.2120	-0.1120	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.2120	-0.1120	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.2120	-0.1120	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.2120	-0.1120	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.2120	-0.1120	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.1060	-0.0060	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.1060	-0.0060	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.1060	-0.0060	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.1060	-0.0060	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.1060	-0.0060	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.1060	-0.0060	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.1060	-0.0060	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.1060	-0.0060	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.1060	-0.0060	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.1060	-0.0060	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	34827	TIORFAN (RACECADOTRILA) 100 MG CA VO UN	3.2000	6.4000	-3.2000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	34827	TIORFAN (RACECADOTRILA) 100 MG CA VO UN	3.2000	6.4000	-3.2000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	34827	TIORFAN (RACECADOTRILA) 100 MG CA VO UN	3.2000	6.4000	-3.2000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	34827	TIORFAN (RACECADOTRILA) 100 MG CA VO UN	3.2000	6.4000	-3.2000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	34827	TIORFAN (RACECADOTRILA) 100 MG CA VO UN	3.2000	3.2000	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	27596	TIRA TESTE PARA GLICOSE UN	1.0400	2.0800	-1.0400	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	27596	TIRA TESTE PARA GLICOSE UN	1.0400	1.0400	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	27596	TIRA TESTE PARA GLICOSE UN	1.0400	1.0400	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	19160	SERINGA DESC 20 ML UN	0.5400	0.5374	0.0026	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	19160	SERINGA DESC 20 ML UN	0.5400	0.5374	0.0026	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	07587	DRAMIN B6 DL (DIMENIDRINATO + PIRIDOXINA +	13.2771	15.4939	-13.2839	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	07587	DRAMIN B6 DL (DIMENIDRINATO + PIRIDOXINA +	11.0637	13.2805	-11.0705	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	31585	RANITIDINA 25 MG/ML 2 ML SI IV IM AP	0.9300	1.8668	-0.9368	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	31585	RANITIDINA 25 MG/ML 2 ML SI IV IM AP	0.9300	0.9334	-0.0034	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	31585	RANITIDINA 25 MG/ML 2 ML SI IV IM AP	0.9300	0.9334	-0.0034	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	19151	SERINGA DESC 10 ML UN	0.6634	1.0003	-0.6703	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	19151	SERINGA DESC 10 ML UN	0.3300	0.6669	-0.3369	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	19151	SERINGA DESC 10 ML UN	0.3300	0.6669	-0.3369	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	19151	SERINGA DESC 10 ML UN	0.3300	0.6669	-0.3369	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	13935	METAMUCIL (PLANTAGO OVATA) 5,85 G PO VO E	2.4600	4.9271	-2.4671	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	37761	ALCOOL ETILICO 70 % ST TP ML	0.0598	0.0662	-0.0362	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	53660	EQUIPO MACRO-GOTAS FLEXIVEL C/ INJETOR LATE	1.5900	1.5900	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	53660	EQUIPO MACRO-GOTAS FLEXIVEL C/ INJETOR LATE	1.5900	1.5900	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	11193	CLOREXIDINA 2 % ST TP ML	0.5300	0.5320	-0.0020	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	05975	COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER	0.7739	0.8059	-0.7759	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	05975	COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER	0.7739	0.8059	-0.7759	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	800720d33fe0defb6121e82dd216d044	JALMO	12786952647	NULL	12786952647	102001	DIARIA DE APARTAMENTO	0.0000	288.8900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	800720d33fe0defb6121e82dd216d044	JALMO	12786952647	NULL	12786952647	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	0.0000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4075	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4075	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00020010	Visita Hospitalar (Paciente Internado)	0.0000	438.0000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	02246	HIDROCORTISONA 100 MG PO IM IV FA	0.0000	2.8300	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	02246	HIDROCORTISONA 100 MG PO IM IV FA	0.0000	5.6700	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	02246	HIDROCORTISONA 100 MG PO IM IV FA	0.0000	5.6700	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	26981	SORO FISIOLOGICO 0,9% 10 ML SI IV AP	0.0000	0.0000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	26981	SORO FISIOLOGICO 0,9% 10 ML SI IV AP	0.0000	0.0000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	26981	SORO FISIOLOGICO 0,9% 10 ML SI IV AP	0.0000	0.0000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	26981	SORO FISIOLOGICO 0,9% 10 ML SI IV AP	0.0000	0.0000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00613	CLINDAMICINA 600 MG 4 ML SI IM IV AP	0.0000	13.0800	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00613	CLINDAMICINA 600 MG 4 ML SI IM IV AP	0.0000	13.0800	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00613	CLINDAMICINA 600 MG 4 ML SI IM IV AP	0.0000	13.0800	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	07802	PIPERACILINA 4 G + TAZOBACTAM 500 MG PO IV FA	0.0000	83.4500	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	08829	Bricanyl 0,5mg Inj. Ampola C/ 1ml	0.0000	3.5900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00090	SERINGA DESC 20 ML UN	0.0000	0.0000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00091	SERINGA DESC 01 ML (INSULINA) UN	0.0000	0.3057	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00091	SERINGA DESC 01 ML (INSULINA) UN	0.0000	0.3057	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00124	LUVA CIRURGICA UN	0.0000	1.4475	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00124	LUVA CIRURGICA UN	0.0000	1.4475	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00124	LUVA CIRURGICA UN	0.0000	1.4475	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00125	LUVA CIRURGICA UN	0.0000	1.4475	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4062	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4062	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4062	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4062	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4062	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4062	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4062	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	01584	NEOSTIGMINA 0,5 MG/ML 1 ML SI IM IV SC AP	0.0000	0.7667	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	01584	NEOSTIGMINA 0,5 MG/ML 1 ML SI IM IV SC AP	0.0000	0.7667	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	01584	NEOSTIGMINA 0,5 MG/ML 1 ML SI IM IV SC AP	0.0000	0.7667	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	01584	NEOSTIGMINA 0,5 MG/ML 1 ML SI IM IV SC AP	0.0000	0.7667	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	01584	NEOSTIGMINA 0,5 MG/ML 1 ML SI IM IV SC AP	0.0000	0.7667	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	01584	NEOSTIGMINA 0,5 MG/ML 1 ML SI IM IV SC AP	0.0000	0.7667	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00170	SORO GLICOSADO 5% 250 ML SI IV BS	0.0000	3.4000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00170	SORO GLICOSADO 5% 250 ML SI IV BS	0.0000	3.4000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	24082	BROMOPRIDA 5 MG/ML 2 ML SI IM IV AP	0.0000	2.7300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00090	SERINGA DESC 20 ML UN	0.0000	0.5371	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00090	SERINGA DESC 20 ML UN	0.0000	0.5371	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00090	SERINGA DESC 20 ML UN	0.0000	0.5371	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00090	SERINGA DESC 20 ML UN	0.0000	0.5371	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00090	SERINGA DESC 20 ML UN	0.0000	0.5371	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00090	SERINGA DESC 20 ML UN	0.0000	0.5371	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00090	SERINGA DESC 20 ML UN	0.0000	0.5371	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00090	SERINGA DESC 20 ML UN	0.0000	0.5371	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00090	SERINGA DESC 20 ML UN	0.0000	0.5371	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4088	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4088	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4088	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1766	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1766	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1766	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1766	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1766	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00090	SERINGA DESC 20 ML UN	0.0000	0.5400	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00090	SERINGA DESC 20 ML UN	0.0000	0.5387	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00090	SERINGA DESC 20 ML UN	0.0000	0.5387	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00090	SERINGA DESC 20 ML UN	0.0000	0.5387	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00090	SERINGA DESC 20 ML UN	0.0000	0.5387	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00090	SERINGA DESC 20 ML UN	0.0000	0.5387	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00090	SERINGA DESC 20 ML UN	0.0000	0.5387	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00090	SERINGA DESC 20 ML UN	0.0000	0.5387	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00090	SERINGA DESC 20 ML UN	0.0000	0.5387	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00090	SERINGA DESC 20 ML UN	0.0000	0.5387	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00090	SERINGA DESC 20 ML UN	0.0000	0.5387	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00090	SERINGA DESC 20 ML UN	0.0000	0.5387	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00090	SERINGA DESC 20 ML UN	0.0000	0.5387	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4070	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12550571048	NULL	12550571048	00124	LUVA CIRURGICA UN	0.0000	1.4473	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12550571048	NULL	12550571048	00125	LUVA CIRURGICA UN	0.0000	1.4473	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12550571048	NULL	12550571048	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12550571048	NULL	12550571048	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12550571048	NULL	12550571048	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4074	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12550571048	NULL	12550571048	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4074	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12550571048	NULL	12550571048	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4074	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12550571048	NULL	12550571048	01611	CLORETO DE POTASSIO 600 MG CA VO UN	0.0000	0.4867	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12550571048	NULL	12550571048	25040014	Fisioterapia Respiratória - em Doente Clínico Internado	0.0000	5.0300	NULL	EXAME NAO AUTORIZADO	2707
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12550571048	NULL	12550571048	25040014	Fisioterapia Respiratória - em Doente Clínico Internado	0.0000	10.0600	NULL	EXAME NAO AUTORIZADO	2707
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12550571048	NULL	12550571048	25040014	Fisioterapia Respiratória - em Doente Clínico Internado	0.0000	10.0600	NULL	EXAME NAO AUTORIZADO	2707
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12550571048	NULL	12550571048	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.0000	0.8089	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12550571048	NULL	12550571048	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1775	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12550571048	NULL	12550571048	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1775	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12550571048	NULL	12550571048	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1775	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12550571048	NULL	12550571048	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1775	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12550571048	NULL	12550571048	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1800	NULL	VALOR APRESENTADO A MAIOR	1705
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12550571048	NULL	12550571048	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1775	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12550571048	NULL	12550571048	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1775	NULL	VALOR APRESENTADO A MAIOR	1705
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12550571048	NULL	12550571048	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1775	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	9ffbbf7340bbd65e9e3baa9406d027f3	MARCO	12261811645	NULL	12261811645	00090	SERINGA DESC 20 ML UN	0.0000	0.5400	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12579183644	NULL	12579183644	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12579183644	NULL	12579183644	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12579183644	NULL	12579183644	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12579183644	NULL	12579183644	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12579183644	NULL	12579183644	35382	COMPRESSAS DE GASES 7.5 X7,5 (11 FIOS ESTERIL) UN	0.0000	0.0000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12579183644	NULL	12579183644	51584	ESPARADRAPO MICROPORE	0.0000	0.2600	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12579183644	NULL	12579183644	51584	ESPARADRAPO MICROPORE	0.0000	0.2600	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12579183644	NULL	12579183644	51584	ESPARADRAPO MICROPORE	0.0000	0.2600	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12579183644	NULL	12579183644	51584	ESPARADRAPO MICROPORE	0.0000	0.2600	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12579183644	NULL	12579183644	51584	ESPARADRAPO MICROPORE	0.0000	0.2600	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12579183644	NULL	12579183644	51588	ESPARADRAPO MICROPORE 50 X 10 CM CM	0.0000	0.2600	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12579183644	NULL	12579183644	00090	SERINGA DESC 20 ML UN	0.0000	0.5367	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	00124	LUVA CIRURGICA UN	0.0000	1.4482	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	00124	LUVA CIRURGICA UN	0.0000	1.4482	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	00124	LUVA CIRURGICA UN	0.0000	1.4482	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	00124	LUVA CIRURGICA UN	0.0000	1.4482	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	00124	LUVA CIRURGICA UN	0.0000	1.4500	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	00124	LUVA CIRURGICA UN	0.0000	1.4500	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	00124	LUVA CIRURGICA UN	0.0000	1.4500	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	00124	LUVA CIRURGICA UN	0.0000	1.4500	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	00128	LUVA DE PROCEDIMENTO UNIDADE UN	0.0000	1.6700	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4094	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.0000	0.4000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1752	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1752	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1752	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1752	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	51241	AGULHA 123X45	0.0000	0.1900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	51590	ABAIXADOR DE LINGUA UN	0.0000	0.0500	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	51649	ALCOOL ETILICO 70 % ST TP ML	0.0000	0.0300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	52392	SONDA DE ASPIRAÇAO TRAQUEAL C/ VALVULA UN	0.0000	0.9400	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	52392	SONDA DE ASPIRAÇAO TRAQUEAL C/ VALVULA UN	0.0000	0.9352	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	52392	SONDA DE ASPIRAÇAO TRAQUEAL C/ VALVULA UN	0.0000	0.9352	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	52392	SONDA DE ASPIRAÇAO TRAQUEAL C/ VALVULA UN	0.0000	0.9400	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	52392	SONDA DE ASPIRAÇAO TRAQUEAL C/ VALVULA UN	0.0000	0.9352	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	35382	COMPRESSAS DE GASES 7.5 X7,5 (11 FIOS ESTERIL) UN	0.0000	0.6000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	35382	COMPRESSAS DE GASES 7.5 X7,5 (11 FIOS ESTERIL) UN	0.0000	0.6000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	35382	COMPRESSAS DE GASES 7.5 X7,5 (11 FIOS ESTERIL) UN	0.0000	0.6000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.3500	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.3500	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	51241	AGULHA 123X45	0.0000	0.5800	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00128	LUVA DE PROCEDIMENTO UNIDADE UN	0.0000	1.6700	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00128	LUVA DE PROCEDIMENTO UNIDADE UN	0.0000	1.6700	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	01496	FENITOINA 50 MG/ML 5 ML SI IM IV AP	0.0000	2.3400	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	01584	NEOSTIGMINA 0,5 MG/ML 1 ML SI IM IV SC AP	0.0000	0.7662	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	01584	NEOSTIGMINA 0,5 MG/ML 1 ML SI IM IV SC AP	0.0000	0.7662	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	01584	NEOSTIGMINA 0,5 MG/ML 1 ML SI IM IV SC AP	0.0000	0.7662	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	24082	BROMOPRIDA 5 MG/ML 2 ML SI IM IV AP	0.0000	2.7300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	26981	SORO FISIOLOGICO 0,9% 10 ML SI IV AP	0.0000	0.9600	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	26981	SORO FISIOLOGICO 0,9% 10 ML SI IV AP	0.0000	0.9600	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	26981	SORO FISIOLOGICO 0,9% 10 ML SI IV AP	0.0000	0.9600	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	ea4ad2636c25d8e3dbb569ae62db71e7	IONE	12489788840	NULL	12489788840	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.0000	0.4000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	ea4ad2636c25d8e3dbb569ae62db71e7	IONE	12489788840	NULL	12489788840	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.0000	0.4000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	d17b3c5ae418d82694895a326dee545a	ODILIA	12670516743	NULL	12670516743	51230	AGULHA DESC 30 X 7 - 40X12 UN	NULL	0.0000	NULL	OPME INVALIDO	2201
Glosa Min	2018-10-03 00:00:00.000000	1084117	d17b3c5ae418d82694895a326dee545a	ODILIA	12670516743	NULL	12670516743	102001	DIARIA DE APARTAMENTO	0.0000	288.8882	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	d17b3c5ae418d82694895a326dee545a	ODILIA	12670516743	NULL	12670516743	01137	SONDA URETRAL N 12 UN	0.0000	0.7500	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	d17b3c5ae418d82694895a326dee545a	ODILIA	12670516743	NULL	12670516743	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	d17b3c5ae418d82694895a326dee545a	ODILIA	12670516743	NULL	12670516743	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	d17b3c5ae418d82694895a326dee545a	ODILIA	12670516743	NULL	12670516743	02197	METAMUCIL (PLANTAGO OVATA) 3,4 G PO VO EV	0.0000	2.4600	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	d17b3c5ae418d82694895a326dee545a	ODILIA	12670516743	NULL	12670516743	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	d17b3c5ae418d82694895a326dee545a	ODILIA	12670516743	NULL	12670516743	00431	ETOMIDATO 2 MG/ML 10 ML SI IV AP	0.0000	7.0000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	d17b3c5ae418d82694895a326dee545a	ODILIA	12670516743	NULL	12670516743	51208	SORO RINGER SIMPLES 500 ML SI IV BS	0.0000	5.9400	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	d17b3c5ae418d82694895a326dee545a	ODILIA	12670516743	NULL	12670516743	51208	SORO RINGER SIMPLES 500 ML SI IV BS	0.0000	5.9400	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1965b0cdebe9017c3397c8641147759	JOSE	12705413746	NULL	12705413746	102001	DIARIA DE APARTAMENTO	0.0000	288.8882	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1965b0cdebe9017c3397c8641147759	JOSE	12705413746	NULL	12705413746	102001	DIARIA DE APARTAMENTO	0.0000	288.8882	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1965b0cdebe9017c3397c8641147759	JOSE	12705413746	NULL	12705413746	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4074	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1965b0cdebe9017c3397c8641147759	JOSE	12705413746	NULL	12705413746	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4074	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4072	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	01611	CLORETO DE POTASSIO 600 MG CA VO UN	0.0000	0.4867	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	02246	HIDROCORTISONA 100 MG PO IM IV FA	0.0000	2.8300	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	02246	HIDROCORTISONA 100 MG PO IM IV FA	0.0000	2.8300	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	02246	HIDROCORTISONA 100 MG PO IM IV FA	0.0000	2.8300	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	25030019	Distúrbios Circulatórios Artério - Venosos e Linfáticos	0.0000	57.3200	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	26981	SORO FISIOLOGICO 0,9% 10 ML SI IV AP	0.0000	0.4800	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	26981	SORO FISIOLOGICO 0,9% 10 ML SI IV AP	0.0000	0.4800	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	26981	SORO FISIOLOGICO 0,9% 10 ML SI IV AP	0.0000	0.4800	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	00404	LACTULOSE 667 MG/ML XP VO ML	0.0000	0.0000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	00404	LACTULOSE 667 MG/ML XP VO ML	0.0000	6.4300	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	00404	LACTULOSE 667 MG/ML XP VO ML	0.0000	6.4300	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	00404	LACTULOSE 667 MG/ML XP VO ML	0.0000	6.4300	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	51163	AGUA BIDESTILADA 250 ML	0.0000	5.4539	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1771	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1771	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1771	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1771	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1771	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1771	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1771	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1771	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1771	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1771	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1771	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	081fdadb830fb547e83c43fabdb88372	ELZA	12377335349	NULL	12377335349	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1800	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	081fdadb830fb547e83c43fabdb88372	ELZA	12377335349	NULL	12377335349	09071	ACETILCISTEINA 600MG PO VO SA	0.0000	3.5000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	00172	SORO FISIOLOGICO 0,9% 500 ML SI IV BS	0.0000	9.4698	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	24571	CLINDAMICINA 600 MG 4 ML SI IM IV AP	0.0000	13.0800	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	24571	CLINDAMICINA 600 MG 4 ML SI IM IV AP	0.0000	13.0800	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	24571	CLINDAMICINA 600 MG 4 ML SI IM IV AP	0.0000	13.0800	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	24571	CLINDAMICINA 600 MG 4 ML SI IM IV AP	0.0000	13.0800	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	dd486d36a88cfef0b44fe652638a0164	DELFINA	12660326244	NULL	12660326244	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR APRESENTADO A MAIOR	1705
Glosa Min	2018-10-03 00:00:00.000000	1084117	dd486d36a88cfef0b44fe652638a0164	DELFINA	12660326244	NULL	12660326244	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR APRESENTADO A MAIOR	1705
Glosa Min	2018-10-03 00:00:00.000000	1084117	dd486d36a88cfef0b44fe652638a0164	DELFINA	12660326244	NULL	12660326244	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	dd486d36a88cfef0b44fe652638a0164	DELFINA	12660326244	NULL	12660326244	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR APRESENTADO A MAIOR	1705
Glosa Min	2018-10-03 00:00:00.000000	1084117	dd486d36a88cfef0b44fe652638a0164	DELFINA	12660326244	NULL	12660326244	25040014	Fisioterapia Respiratória - em Doente Clínico Internado	0.0000	15.4600	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	dd486d36a88cfef0b44fe652638a0164	DELFINA	12660326244	NULL	12660326244	26981	SORO FISIOLOGICO 0,9% 10 ML SI IV AP	0.0000	0.9600	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	dd486d36a88cfef0b44fe652638a0164	DELFINA	12660326244	NULL	12660326244	03280	CLOREXIDINA 2 % ST TP ML	0.0000	0.5300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	dd486d36a88cfef0b44fe652638a0164	DELFINA	12660326244	NULL	12660326244	03280	CLOREXIDINA 2 % ST TP ML	0.0000	0.8000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	dd486d36a88cfef0b44fe652638a0164	DELFINA	12660326244	NULL	12660326244	00406	FUROSEMIDA 10 MG/ML 2 ML SI IM IV AP	0.0000	0.6000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	dd486d36a88cfef0b44fe652638a0164	DELFINA	12660326244	NULL	12660326244	00406	FUROSEMIDA 10 MG/ML 2 ML SI IM IV AP	0.0000	0.6000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	dd486d36a88cfef0b44fe652638a0164	DELFINA	12660326244	NULL	12660326244	00406	FUROSEMIDA 10 MG/ML 2 ML SI IM IV AP	0.0000	0.6000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	dd486d36a88cfef0b44fe652638a0164	DELFINA	12660326244	NULL	12660326244	00487	RANITIDINA 25 MG/ML 2 ML SI IM IV AP	0.0000	0.9300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	dd486d36a88cfef0b44fe652638a0164	DELFINA	12660326244	NULL	12660326244	00487	RANITIDINA 25 MG/ML 2 ML SI IM IV AP	0.0000	0.9300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	dd486d36a88cfef0b44fe652638a0164	DELFINA	12660326244	NULL	12660326244	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.0000	0.8100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	dd486d36a88cfef0b44fe652638a0164	DELFINA	12660326244	NULL	12660326244	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.0000	0.8100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	dd486d36a88cfef0b44fe652638a0164	DELFINA	12660326244	NULL	12660326244	51379	SERINGA DESC 05 ML UN	0.0000	0.1900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	dd486d36a88cfef0b44fe652638a0164	DELFINA	12660326244	NULL	12660326244	51379	SERINGA DESC 05 ML UN	0.0000	0.1900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	dd486d36a88cfef0b44fe652638a0164	DELFINA	12660326244	NULL	12660326244	51379	SERINGA DESC 05 ML UN	0.0000	0.1900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	dd486d36a88cfef0b44fe652638a0164	DELFINA	12660326244	NULL	12660326244	51379	SERINGA DESC 05 ML UN	0.0000	0.1900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	dd486d36a88cfef0b44fe652638a0164	DELFINA	12660326244	NULL	12660326244	51379	SERINGA DESC 05 ML UN	0.0000	0.1900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	dd486d36a88cfef0b44fe652638a0164	DELFINA	12660326244	NULL	12660326244	51379	SERINGA DESC 05 ML UN	0.0000	0.1900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	dd486d36a88cfef0b44fe652638a0164	DELFINA	12660326244	NULL	12660326244	51589	ESPARADRAPO 10 X 4.5 CM CM	0.0000	0.4000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	dd486d36a88cfef0b44fe652638a0164	DELFINA	12660326244	NULL	12660326244	51589	ESPARADRAPO 10 X 4.5 CM CM	0.0000	0.4000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	dd486d36a88cfef0b44fe652638a0164	DELFINA	12660326244	NULL	12660326244	51589	ESPARADRAPO 10 X 4.5 CM CM	0.0000	0.4000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	dd486d36a88cfef0b44fe652638a0164	DELFINA	12660326244	NULL	12660326244	52941	Clorexidina Degermante 2% Fr30ml - Solução De Uso Tópico	0.0000	0.8000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	dd486d36a88cfef0b44fe652638a0164	DELFINA	12660326244	NULL	12660326244	06400	CARVEDILOL 3,125 MG CP VO UN	0.0000	0.7300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	dd486d36a88cfef0b44fe652638a0164	DELFINA	12660326244	NULL	12660326244	06400	CARVEDILOL 3,125 MG CP VO UN	0.0000	0.7300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	dd486d36a88cfef0b44fe652638a0164	DELFINA	12660326244	NULL	12660326244	06400	CARVEDILOL 3,125 MG CP VO UN	0.0000	0.7300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	102001	DIARIA DE APARTAMENTO	0.0000	288.8900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	102001	DIARIA DE APARTAMENTO	0.0000	288.8900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	01062	CATETER OXIGENIO TIPO OCULOS UN	0.0000	0.6757	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	00128	LUVA DE PROCEDIMENTO UNIDADE UN	0.0000	1.0000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	51589	ESPARADRAPO 10 X 4.5 CM CM	0.0000	0.4000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	51649	ALCOOL ETILICO 70 % ST TP ML	0.0000	0.0300	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	00090	SERINGA DESC 20 ML UN	0.0000	0.5400	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	00090	SERINGA DESC 20 ML UN	0.0000	0.5400	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	00090	SERINGA DESC 20 ML UN	0.0000	0.5400	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	00090	SERINGA DESC 20 ML UN	0.0000	0.5400	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	00090	SERINGA DESC 20 ML UN	0.0000	0.5400	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	00090	SERINGA DESC 20 ML UN	0.0000	0.5400	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	00090	SERINGA DESC 20 ML UN	0.0000	0.5400	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	00919	ALGODAO HIDROFILO BOLINHA UN	0.0000	0.2600	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	f3ad474c8c562757c4d1a959ff0961c4	DJALMA	12718763240	NULL	12718763240	11700	EQUIPO P/ BOMBA DE INFUSAO ENTERAL / PARENTERAL	0.0000	0.0000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	f3ad474c8c562757c4d1a959ff0961c4	DJALMA	12718763240	NULL	12718763240	00037	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	f3ad474c8c562757c4d1a959ff0961c4	DJALMA	12718763240	NULL	12718763240	51584	ESPARADRAPO MICROPORE	0.0000	0.7700	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	f3ad474c8c562757c4d1a959ff0961c4	DJALMA	12718763240	NULL	12718763240	51584	ESPARADRAPO MICROPORE	0.0000	0.7700	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	f3ad474c8c562757c4d1a959ff0961c4	DJALMA	12718763240	NULL	12718763240	00090	SERINGA DESC 20 ML UN	0.0000	0.5400	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	f3ad474c8c562757c4d1a959ff0961c4	DJALMA	12718763240	NULL	12718763240	00090	SERINGA DESC 20 ML UN	0.0000	0.5400	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	806bfa8e76209648a4ae145ff436d092	GILBERTO	12692620640	NULL	12692620640	16961	CLOPIDOGREL 75 MG CP VO UN	0.0000	1.7900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	806bfa8e76209648a4ae145ff436d092	GILBERTO	12692620640	NULL	12692620640	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.0000	0.6875	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	806bfa8e76209648a4ae145ff436d092	GILBERTO	12692620640	NULL	12692620640	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.0000	0.6900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3fb5c891f31bb9efcb05395066127c52	ALAIDE	12636273441	NULL	12636273441	14250	PARACETAMOL 750 MG CP VO UN	0.0000	0.0000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00090	SERINGA DESC 20 ML UN	0.5400	0.2200	0.3200	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.6900	0.2700	0.4200	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.6900	0.2700	0.4200	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00128	LUVA DE PROCEDIMENTO UNIDADE UN	1.0000	0.3900	0.6100	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00493	BROMOPRIDA 5 MG/ML 2 ML SI IM IV AP	2.7300	1.0600	1.6700	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00493	BROMOPRIDA 5 MG/ML 2 ML SI IM IV AP	2.7300	1.0600	1.6700	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00493	BROMOPRIDA 5 MG/ML 2 ML SI IM IV AP	2.7300	1.0600	1.6700	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00493	BROMOPRIDA 5 MG/ML 2 ML SI IM IV AP	2.7300	1.0600	1.6700	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	01603	GLICOSE 50% 10 ML SI IV AP	2.7400	1.0700	1.6700	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00407	HEPARINA 5000 UI/ML 5 ML SI IV SC ML	2.8800	1.1200	1.7600	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00124	LUVA CIRURGICA UN	2.9000	1.1300	1.7700	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00172	SORO FISIOLOGICO 0,9% 500 ML SI IV BS	4.7300	1.8400	2.8900	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	51163	AGUA BIDESTILADA 250 ML	5.7900	2.2600	3.5300	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	51620	Modulo Em Pó De Fibras Solúveis	7.3100	2.8500	4.4600	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00613	CLINDAMICINA 600 MG 4 ML SI IM IV AP	13.0800	5.1000	7.9800	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00613	CLINDAMICINA 600 MG 4 ML SI IM IV AP	13.0800	5.1000	7.9800	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00613	CLINDAMICINA 600 MG 4 ML SI IM IV AP	13.0800	5.1000	7.9800	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	51673	ALGINATO DE CALCIO EM HIDROGEL GL TP GR	17.2500	6.7300	10.5200	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	16b1e9f62f247f02ad5cac910ee15b4e	BERCHOLINA	12631612848	NULL	12631612848	33537	PIPERACILINA 2 G + TAZOBACTAM 250 MG 30 ML	55.3400	55.3385	0.0015	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	16b1e9f62f247f02ad5cac910ee15b4e	BERCHOLINA	12631612848	NULL	12631612848	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4081	0.0019	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	16b1e9f62f247f02ad5cac910ee15b4e	BERCHOLINA	12631612848	NULL	12631612848	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4081	0.0019	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	16b1e9f62f247f02ad5cac910ee15b4e	BERCHOLINA	12631612848	NULL	12631612848	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1900	0.1781	0.0119	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	16b1e9f62f247f02ad5cac910ee15b4e	BERCHOLINA	12631612848	NULL	12631612848	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1900	0.1781	0.0119	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	16b1e9f62f247f02ad5cac910ee15b4e	BERCHOLINA	12631612848	NULL	12631612848	33219	LUVA DE PROCEDIMENTO UNIDADE UN	0.8370	1.0018	-0.3318	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	16b1e9f62f247f02ad5cac910ee15b4e	BERCHOLINA	12631612848	NULL	12631612848	33219	LUVA DE PROCEDIMENTO UNIDADE UN	0.8370	1.0018	-0.3318	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	16b1e9f62f247f02ad5cac910ee15b4e	BERCHOLINA	12631612848	NULL	12631612848	36432	HIDROCLOROTIAZIDA 25 MG CP VO UN	0.2400	0.2300	0.0100	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	16b1e9f62f247f02ad5cac910ee15b4e	BERCHOLINA	12631612848	NULL	12631612848	36432	HIDROCLOROTIAZIDA 25 MG CP VO UN	0.2400	0.2300	0.0100	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	16b1e9f62f247f02ad5cac910ee15b4e	BERCHOLINA	12631612848	NULL	12631612848	00090	SERINGA DESC 20 ML UN	0.5400	0.5200	0.0200	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	16b1e9f62f247f02ad5cac910ee15b4e	BERCHOLINA	12631612848	NULL	12631612848	00090	SERINGA DESC 20 ML UN	0.5400	0.5200	0.0200	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	16b1e9f62f247f02ad5cac910ee15b4e	BERCHOLINA	12631612848	NULL	12631612848	00090	SERINGA DESC 20 ML UN	0.5400	0.5200	0.0200	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	16b1e9f62f247f02ad5cac910ee15b4e	BERCHOLINA	12631612848	NULL	12631612848	00171	SORO FISIOLOGICO 0,9% 250 ML SI IV BS	3.9400	3.7600	0.1800	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12550571048	NULL	12550571048	37761	ALCOOL ETILICO 70 % ST TP ML	0.0300	0.0200	0.0100	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12550571048	NULL	12550571048	33219	LUVA DE PROCEDIMENTO UNIDADE UN	1.6700	0.6700	1.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12550571048	NULL	12550571048	00817	ALGODAO HIDROFILO BOLINHA UN	0.5100	0.1300	0.3800	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12550571048	NULL	12550571048	08648	ESPARADRAPO 10 X 4.5 CM CM	0.4000	0.2000	0.2000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12550571048	NULL	12550571048	08648	ESPARADRAPO 10 X 4.5 CM CM	0.4000	0.2000	0.2000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12550571048	NULL	12550571048	37761	ALCOOL ETILICO 70 % ST TP ML	0.0600	0.0200	0.0400	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	00817	ALGODAO HIDROFILO BOLINHA UN	0.5100	0.2600	0.2500	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	32891	EQUIPO POLIFIX 2ş VIAS UN	2.5500	0.0000	2.5500	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	00817	ALGODAO HIDROFILO BOLINHA UN	0.5100	0.2600	0.2500	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	28959	DERSANI LC TP ML	19.4000	4.8500	14.5500	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	75bcd473a0dc7c7a6751499b38a4a034	JOAQUIM	12692852143	NULL	12692852143	08648	ESPARADRAPO 10 X 4.5 CM CM	0.4000	0.1000	0.3000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	75bcd473a0dc7c7a6751499b38a4a034	JOAQUIM	12692852143	NULL	12692852143	08664	ESPARADRAPO MICROPORE 50 X 10 CM CM	0.7700	0.0000	0.7700	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	75bcd473a0dc7c7a6751499b38a4a034	JOAQUIM	12692852143	NULL	12692852143	08648	ESPARADRAPO 10 X 4.5 CM CM	0.4000	0.1000	0.3000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	00426	AGUA BIDESTILADA 10 ML SI IV IM AP	0.8100	0.0000	0.8100	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	14370	FIO MONONYLON 3-0 C/ AGULHA 2,4 3/8 163T E	13.3700	0.0000	13.3700	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	05975	COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER	0.0900	0.0000	0.0900	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12603877940	NULL	12603877940	19151	SERINGA DESC 10 ML UN	0.3300	0.0000	0.3300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	08648	ESPARADRAPO 10 X 4.5 CM CM	0.4000	0.2600	0.1400	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	05975	COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER	0.3000	0.0000	0.3000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	33219	LUVA DE PROCEDIMENTO UNIDADE UN	1.0000	0.6700	0.3300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	37761	ALCOOL ETILICO 70 % ST TP ML	0.0300	0.0200	0.0100	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	37761	ALCOOL ETILICO 70 % ST TP ML	0.0300	0.0200	0.0100	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	11193	CLOREXIDINA 2 % ST TP ML	0.8000	0.0000	0.8000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	11193	CLOREXIDINA 2 % ST TP ML	0.8000	0.0000	0.8000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	11193	CLOREXIDINA 2 % ST TP ML	0.8000	0.2700	0.5300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00817	ALGODAO HIDROFILO BOLINHA UN	0.2600	0.1300	0.1300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1965b0cdebe9017c3397c8641147759	JOSE	12705413746	NULL	12705413746	05975	COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER	0.6000	0.0000	0.6000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12558131243	NULL	12558131243	08648	ESPARADRAPO 10 X 4.5 CM CM	0.4000	0.2600	0.1400	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12558131243	NULL	12558131243	08648	ESPARADRAPO 10 X 4.5 CM CM	0.4000	0.2600	0.1400	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12558131243	NULL	12558131243	05975	COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER	0.9000	0.3800	0.5200	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12558131243	NULL	12558131243	08664	ESPARADRAPO MICROPORE 50 X 10 CM CM	0.7700	0.2600	0.5100	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	33936	CEFTRIAXONA IV 1G + DIL. 10 ML PO IV FA	54.1300	0.0000	54.1300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00817	ALGODAO HIDROFILO BOLINHA UN	0.2600	0.1300	0.1300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00817	ALGODAO HIDROFILO BOLINHA UN	0.2600	0.1300	0.1300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	7c2bc8cd9bbf9ce081562a3c63fff8c9	MARTA	12647505849	NULL	12647505849	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1756	0.0044	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	7c2bc8cd9bbf9ce081562a3c63fff8c9	MARTA	12647505849	NULL	12647505849	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1756	0.0044	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	f65f553befc0e3bc8bd5bce5c1c6e413	NAIRLENE	12633078944	NULL	12633078944	19160	SERINGA DESC 20 ML UN	0.5400	0.5367	0.0033	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	f65f553befc0e3bc8bd5bce5c1c6e413	NAIRLENE	12633078944	NULL	12633078944	19160	SERINGA DESC 20 ML UN	0.5400	0.5367	0.0033	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	f65f553befc0e3bc8bd5bce5c1c6e413	NAIRLENE	12633078944	NULL	12633078944	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4067	0.0033	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	f65f553befc0e3bc8bd5bce5c1c6e413	NAIRLENE	12633078944	NULL	12633078944	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1760	0.0040	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	f65f553befc0e3bc8bd5bce5c1c6e413	NAIRLENE	12633078944	NULL	12633078944	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1760	0.0040	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	f65f553befc0e3bc8bd5bce5c1c6e413	NAIRLENE	12633078944	NULL	12633078944	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1760	0.0040	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	f65f553befc0e3bc8bd5bce5c1c6e413	NAIRLENE	12633078944	NULL	12633078944	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1760	0.0040	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	f65f553befc0e3bc8bd5bce5c1c6e413	NAIRLENE	12633078944	NULL	12633078944	07269	DIPIRONA 500 MG/ML 2 ML SI IV IM AP	0.6900	0.6867	0.0033	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	f65f553befc0e3bc8bd5bce5c1c6e413	NAIRLENE	12633078944	NULL	12633078944	07269	DIPIRONA 500 MG/ML 2 ML SI IV IM AP	0.6900	0.6867	0.0033	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	f65f553befc0e3bc8bd5bce5c1c6e413	NAIRLENE	12633078944	NULL	12633078944	07269	DIPIRONA 500 MG/ML 2 ML SI IV IM AP	0.6900	0.6867	0.0033	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	c2bcdc3cbedb73a0db271ac09d4587a1	ORDETE	12694018147	NULL	12694018147	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1760	0.0040	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	f93cee6f501560245a8f94ffc5c6c246	ROSEDALIA	12622895145	NULL	12622895145	19160	SERINGA DESC 20 ML UN	0.5400	0.5373	0.0027	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	026c6dcfddc3d74250c79f449289696a	SALOMAO	12456038443	NULL	12456038443	102001	DIARIA DE APARTAMENTO SIMPLES	288.8900	288.8800	0.0000	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	026c6dcfddc3d74250c79f449289696a	SALOMAO	12456038443	NULL	12456038443	12262	ISOSSORBIDA 20 MG CP VO UN	0.2200	0.2150	0.0050	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	d4089ccef13567fd45b16fb0b60685fa	VERA	12640482546	NULL	12640482546	00035	ABOCATH (CATETER INTRAVENOSO) N. 14 A 22 UN	3.7700	3.7600	0.0000	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	d4089ccef13567fd45b16fb0b60685fa	VERA	12640482546	NULL	12640482546	27480	CLARITROMICINA 500 MG 30 ML PO IV FA	117.1100	117.1050	0.0050	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	d4089ccef13567fd45b16fb0b60685fa	VERA	12640482546	NULL	12640482546	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1754	0.0046	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	d4089ccef13567fd45b16fb0b60685fa	VERA	12640482546	NULL	12640482546	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1754	0.0046	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	d4089ccef13567fd45b16fb0b60685fa	VERA	12640482546	NULL	12640482546	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1754	0.0046	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	d4089ccef13567fd45b16fb0b60685fa	VERA	12640482546	NULL	12640482546	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1754	0.0046	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	d4089ccef13567fd45b16fb0b60685fa	VERA	12640482546	NULL	12640482546	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1754	0.0046	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	d4089ccef13567fd45b16fb0b60685fa	VERA	12640482546	NULL	12640482546	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1754	0.0046	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	eecb3d883747b059c3fe231c34567476	AFFRIDES	12693180144	NULL	12693180144	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4074	0.0026	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	eecb3d883747b059c3fe231c34567476	AFFRIDES	12693180144	NULL	12693180144	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4074	0.0026	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	eecb3d883747b059c3fe231c34567476	AFFRIDES	12693180144	NULL	12693180144	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4074	0.0026	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	eecb3d883747b059c3fe231c34567476	AFFRIDES	12693180144	NULL	12693180144	19160	SERINGA DESC 20 ML UN	0.5400	0.5372	0.0028	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	eecb3d883747b059c3fe231c34567476	AFFRIDES	12693180144	NULL	12693180144	19160	SERINGA DESC 20 ML UN	0.5400	0.5372	0.0028	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	eecb3d883747b059c3fe231c34567476	AFFRIDES	12693180144	NULL	12693180144	19160	SERINGA DESC 20 ML UN	0.5400	0.5372	0.0028	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	eecb3d883747b059c3fe231c34567476	AFFRIDES	12693180144	NULL	12693180144	19160	SERINGA DESC 20 ML UN	0.5400	0.5372	0.0028	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	eecb3d883747b059c3fe231c34567476	AFFRIDES	12693180144	NULL	12693180144	19160	SERINGA DESC 20 ML UN	0.5400	0.5372	0.0028	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	eecb3d883747b059c3fe231c34567476	AFFRIDES	12693180144	NULL	12693180144	19160	SERINGA DESC 20 ML UN	0.5400	0.5372	0.0028	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	eecb3d883747b059c3fe231c34567476	AFFRIDES	12693180144	NULL	12693180144	19160	SERINGA DESC 20 ML UN	0.5400	0.5372	0.0028	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1d6bbb4a00130e2e654e830fc9bae6a	ALEXANDRINA	12694224940	NULL	12694224940	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4072	0.0028	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1d6bbb4a00130e2e654e830fc9bae6a	ALEXANDRINA	12694224940	NULL	12694224940	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4072	0.0028	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	345c226bfea274af1372d41b0305a6c8	ALTINO	12720257940	NULL	12720257940	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.1000	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	345c226bfea274af1372d41b0305a6c8	ALTINO	12720257940	NULL	12720257940	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.1000	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	345c226bfea274af1372d41b0305a6c8	ALTINO	12720257940	NULL	12720257940	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.1000	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	345c226bfea274af1372d41b0305a6c8	ALTINO	12720257940	NULL	12720257940	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.1000	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.1038	-0.0038	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.1038	-0.0038	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.1038	-0.0038	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.1038	-0.0038	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.1038	-0.0038	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.1038	-0.0038	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.1038	-0.0038	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.1038	-0.0038	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	19160	SERINGA DESC 20 ML UN	0.5400	0.5378	0.0022	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	19160	SERINGA DESC 20 ML UN	0.5400	0.5378	0.0022	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1797	0.0003	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1797	0.0003	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1797	0.0003	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1797	0.0003	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	00426	AGUA BIDESTILADA 10 ML SI IV IM AP	0.4000	0.4045	-0.0045	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	08435	EQUIPO P/ BOMBA DE INFUSAO ENTERAL / PARENT	20.2800	20.2780	0.0020	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	20567	SORO FISIOLOGICO 0,9% 500 ML SI IV BS	4.7300	4.7350	-0.0050	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12550571048	NULL	12550571048	53660	EQUIPO MACRO-GOTAS FLEXIVEL C/ INJETOR LATE	1.5900	0.0000	1.5900	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12550571048	NULL	12550571048	05975	COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER	0.3000	0.0000	0.3000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12550571048	NULL	12550571048	05975	COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER	0.6000	0.1500	0.4500	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	670141098c0309ac9be3db204bdc12cf	LEOSINA	12706525442	NULL	12706525442	02461	FENOTEROL 2 MG/ML 10 ML AE IN DS	0.4300	0.4250	0.0050	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	20cbe2e07b1dcd2b6af609a50df7ae80	LUCELENA	12690767849	NULL	12690767849	00817	ALGODAO HIDROFILO BOLINHA UN	0.5100	0.2600	0.2500	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	20cbe2e07b1dcd2b6af609a50df7ae80	LUCELENA	12690767849	NULL	12690767849	27480	CLARITROMICINA 500 MG 30 ML PO IV FA	117.1100	117.1050	0.0050	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	20cbe2e07b1dcd2b6af609a50df7ae80	LUCELENA	12690767849	NULL	12690767849	27480	CLARITROMICINA 500 MG 30 ML PO IV FA	117.1100	117.1050	0.0050	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	20cbe2e07b1dcd2b6af609a50df7ae80	LUCELENA	12690767849	NULL	12690767849	07269	DIPIRONA 500 MG/ML 2 ML SI IV IM AP	0.6900	0.6850	0.0050	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	20cbe2e07b1dcd2b6af609a50df7ae80	LUCELENA	12690767849	NULL	12690767849	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1758	0.0042	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	20cbe2e07b1dcd2b6af609a50df7ae80	LUCELENA	12690767849	NULL	12690767849	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1758	0.0042	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	20cbe2e07b1dcd2b6af609a50df7ae80	LUCELENA	12690767849	NULL	12690767849	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1758	0.0042	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	20cbe2e07b1dcd2b6af609a50df7ae80	LUCELENA	12690767849	NULL	12690767849	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1758	0.0042	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	20cbe2e07b1dcd2b6af609a50df7ae80	LUCELENA	12690767849	NULL	12690767849	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4084	0.0016	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	20cbe2e07b1dcd2b6af609a50df7ae80	LUCELENA	12690767849	NULL	12690767849	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4084	0.0016	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	20cbe2e07b1dcd2b6af609a50df7ae80	LUCELENA	12690767849	NULL	12690767849	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4084	0.0016	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	20cbe2e07b1dcd2b6af609a50df7ae80	LUCELENA	12690767849	NULL	12690767849	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4084	0.0016	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	20cbe2e07b1dcd2b6af609a50df7ae80	LUCELENA	12690767849	NULL	12690767849	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4084	0.0016	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	20cbe2e07b1dcd2b6af609a50df7ae80	LUCELENA	12690767849	NULL	12690767849	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4084	0.0016	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	20cbe2e07b1dcd2b6af609a50df7ae80	LUCELENA	12690767849	NULL	12690767849	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4084	0.0016	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	20cbe2e07b1dcd2b6af609a50df7ae80	LUCELENA	12690767849	NULL	12690767849	19160	SERINGA DESC 20 ML UN	0.5400	0.5384	0.0016	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	20cbe2e07b1dcd2b6af609a50df7ae80	LUCELENA	12690767849	NULL	12690767849	19160	SERINGA DESC 20 ML UN	0.5400	0.5384	0.0016	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	20cbe2e07b1dcd2b6af609a50df7ae80	LUCELENA	12690767849	NULL	12690767849	19160	SERINGA DESC 20 ML UN	0.5400	0.5384	0.0016	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	19445	CLORETO DE POTASSIO 600 MG CA VO UN	0.4900	0.4867	0.0033	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	19445	CLORETO DE POTASSIO 600 MG CA VO UN	0.4900	0.4867	0.0033	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	19445	CLORETO DE POTASSIO 600 MG CA VO UN	0.4900	0.4867	0.0033	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4075	0.0025	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4075	0.0025	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4075	0.0025	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4075	0.0025	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	07269	DIPIRONA 500 MG/ML 2 ML SI IV IM AP	0.6900	0.6865	0.0035	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	07269	DIPIRONA 500 MG/ML 2 ML SI IV IM AP	0.6900	0.6865	0.0035	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	07269	DIPIRONA 500 MG/ML 2 ML SI IV IM AP	0.6900	0.6865	0.0035	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	07269	DIPIRONA 500 MG/ML 2 ML SI IV IM AP	0.6900	0.6865	0.0035	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	07269	DIPIRONA 500 MG/ML 2 ML SI IV IM AP	0.6900	0.6865	0.0035	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	07269	DIPIRONA 500 MG/ML 2 ML SI IV IM AP	0.6900	0.6865	0.0035	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	07269	DIPIRONA 500 MG/ML 2 ML SI IV IM AP	0.6900	0.6865	0.0035	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	07269	DIPIRONA 500 MG/ML 2 ML SI IV IM AP	0.6900	0.6865	0.0035	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	07269	DIPIRONA 500 MG/ML 2 ML SI IV IM AP	0.6900	0.6865	0.0035	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	19160	SERINGA DESC 20 ML UN	0.5400	0.5375	0.0025	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	19160	SERINGA DESC 20 ML UN	0.5400	0.5375	0.0025	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1769	0.0031	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1769	0.0031	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1769	0.0031	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1769	0.0031	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00426	AGUA BIDESTILADA 10 ML SI IV IM AP	0.8100	0.8073	0.0027	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	33227	LUVA CIRURGICA PAR UN	1.4500	1.4477	0.0023	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	19160	SERINGA DESC 20 ML UN	0.5400	0.5372	0.0028	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	19160	SERINGA DESC 20 ML UN	0.5400	0.5372	0.0028	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	19160	SERINGA DESC 20 ML UN	0.5400	0.5372	0.0028	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	19160	SERINGA DESC 20 ML UN	0.5400	0.5372	0.0028	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	19160	SERINGA DESC 20 ML UN	0.5400	0.5372	0.0028	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	19160	SERINGA DESC 20 ML UN	0.5400	0.5372	0.0028	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	19160	SERINGA DESC 20 ML UN	0.5400	0.5372	0.0028	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	19160	SERINGA DESC 20 ML UN	0.5400	0.5372	0.0028	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	19160	SERINGA DESC 20 ML UN	0.5400	0.5372	0.0028	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1779	0.0021	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1779	0.0021	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1779	0.0021	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1779	0.0021	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1779	0.0021	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1779	0.0021	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1779	0.0021	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1779	0.0021	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	00426	AGUA BIDESTILADA 10 ML SI IV IM AP	0.8100	0.8092	0.0008	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	11193	CLOREXIDINA 2 % ST TP ML	0.5300	0.5320	-0.0020	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	11193	CLOREXIDINA 2 % ST TP ML	0.5300	0.5320	-0.0020	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	08664	ESPARADRAPO MICROPORE 50 X 10 CM CM	0.2600	0.2558	0.0042	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	08664	ESPARADRAPO MICROPORE 50 X 10 CM CM	0.2600	0.2558	0.0042	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	e2b254ce765be196b019032789d8f852	MARIA	12576216044	NULL	12576216044	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4078	0.0022	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	e2b254ce765be196b019032789d8f852	MARIA	12576216044	NULL	12576216044	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4078	0.0022	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	32891	EQUIPO POLIFIX 2ş VIAS UN	2.5500	2.5500	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	19135	SERINGA DESC 03 ML UN	0.1500	0.0000	0.1500	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	19135	SERINGA DESC 03 ML UN	0.1500	0.0000	0.1500	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	20559	SORO FISIOLOGICO 0,9% 250 ML SI IV BS	7.8900	3.9400	3.9500	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	6ccea6ac8c216c032723aee73a9f81c9	PRISCILA	12662249242	NULL	12662249242	50385	CETOPROFENO 100 MG PO IV FA	7.7800	7.7700	0.0000	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	6ccea6ac8c216c032723aee73a9f81c9	PRISCILA	12662249242	NULL	12662249242	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4067	0.0033	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	6ccea6ac8c216c032723aee73a9f81c9	PRISCILA	12662249242	NULL	12662249242	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4067	0.0033	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	6ccea6ac8c216c032723aee73a9f81c9	PRISCILA	12662249242	NULL	12662249242	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4067	0.0033	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	6ccea6ac8c216c032723aee73a9f81c9	PRISCILA	12662249242	NULL	12662249242	20672	SORO RINGER SIMPLES 500 ML SI IV BS	5.9400	5.9375	0.0025	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	6ccea6ac8c216c032723aee73a9f81c9	PRISCILA	12662249242	NULL	12662249242	07269	DIPIRONA 500 MG/ML 2 ML SI IV IM AP	0.6900	0.6860	0.0040	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	6ccea6ac8c216c032723aee73a9f81c9	PRISCILA	12662249242	NULL	12662249242	07269	DIPIRONA 500 MG/ML 2 ML SI IV IM AP	0.6900	0.6864	0.0036	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	6ccea6ac8c216c032723aee73a9f81c9	PRISCILA	12662249242	NULL	12662249242	19160	SERINGA DESC 20 ML UN	0.5400	0.5373	0.0027	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.1000	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.1000	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.1000	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.1000	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.1000	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.1000	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.1000	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.1000	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.2100	0.2100	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	33227	LUVA CIRURGICA PAR UN	1.4500	1.4476	0.0024	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	33227	LUVA CIRURGICA PAR UN	1.4500	1.4476	0.0024	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	19151	SERINGA DESC 10 ML UN	0.3300	0.3333	-0.0033	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	19151	SERINGA DESC 10 ML UN	0.3300	0.3333	-0.0033	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	19160	SERINGA DESC 20 ML UN	0.5400	0.5384	0.0016	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	19160	SERINGA DESC 20 ML UN	0.5400	0.5384	0.0016	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	19160	SERINGA DESC 20 ML UN	0.5400	0.5384	0.0016	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	19160	SERINGA DESC 20 ML UN	0.5400	0.5384	0.0016	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	19160	SERINGA DESC 20 ML UN	0.5400	0.5384	0.0016	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1776	0.0024	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1776	0.0024	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1776	0.0024	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1776	0.0024	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1776	0.0024	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1776	0.0024	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	00426	AGUA BIDESTILADA 10 ML SI IV IM AP	0.8100	0.8092	0.0008	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	00426	AGUA BIDESTILADA 10 ML SI IV IM AP	0.8100	0.8092	0.0008	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	11193	CLOREXIDINA 2 % ST TP ML	0.5300	0.5300	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	6799aa3de305405ab065aad5b599765c	VANIR	12700232345	NULL	12700232345	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1750	0.0050	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	0111beed375944f60c7ad4a7fd4874f8	WALDIR	12746025744	NULL	12746025744	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1773	0.0027	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	0111beed375944f60c7ad4a7fd4874f8	WALDIR	12746025744	NULL	12746025744	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1773	0.0027	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	0111beed375944f60c7ad4a7fd4874f8	WALDIR	12746025744	NULL	12746025744	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1773	0.0027	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	05975	COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER	0.3000	0.0000	0.3000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	05975	COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER	0.3000	0.3000	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	05975	COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER	0.3000	0.0000	0.3000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	29661	NOREPINEFRINA 2 MG/ML 4 ML SI IV AP	37.9900	37.9850	0.0050	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00426	AGUA BIDESTILADA 10 ML SI IV IM AP	0.8100	0.8079	0.0021	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00426	AGUA BIDESTILADA 10 ML SI IV IM AP	0.8100	0.8079	0.0021	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	08435	EQUIPO P/ BOMBA DE INFUSAO ENTERAL / PARENT	20.2800	20.2775	0.0025	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	610c198ec4c064687cf0524f147d3aed	ROBERTO	12748814743	NULL	12748814743	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1759	0.0041	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	610c198ec4c064687cf0524f147d3aed	ROBERTO	12748814743	NULL	12748814743	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1767	0.0033	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	610c198ec4c064687cf0524f147d3aed	ROBERTO	12748814743	NULL	12748814743	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1767	0.0033	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	610c198ec4c064687cf0524f147d3aed	ROBERTO	12748814743	NULL	12748814743	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1767	0.0033	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	610c198ec4c064687cf0524f147d3aed	ROBERTO	12748814743	NULL	12748814743	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1767	0.0033	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	610c198ec4c064687cf0524f147d3aed	ROBERTO	12748814743	NULL	12748814743	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4083	0.0017	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	610c198ec4c064687cf0524f147d3aed	ROBERTO	12748814743	NULL	12748814743	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4083	0.0017	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12647284040	NULL	12647284040	07269	DIPIRONA 500 MG/ML 2 ML SI IV IM AP	0.6900	0.6800	0.0000	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12647284040	NULL	12647284040	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4080	0.0020	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12647284040	NULL	12647284040	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1750	0.0050	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12647284040	NULL	12647284040	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1750	0.0050	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12647284040	NULL	12647284040	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1750	0.0050	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12647284040	NULL	12647284040	08664	ESPARADRAPO MICROPORE 50 X 10 CM CM	0.7700	0.7667	0.0033	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12647284040	NULL	12647284040	08664	ESPARADRAPO MICROPORE 50 X 10 CM CM	0.7700	0.7667	0.0033	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12647284040	NULL	12647284040	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4086	0.0014	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12647284040	NULL	12647284040	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4086	0.0014	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12647284040	NULL	12647284040	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4086	0.0014	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12647284040	NULL	12647284040	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4086	0.0014	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12647284040	NULL	12647284040	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4086	0.0014	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12647284040	NULL	12647284040	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4086	0.0014	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	08435	EQUIPO P/ BOMBA DE INFUSAO ENTERAL / PARENT	20.2800	20.2775	0.0025	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	08435	EQUIPO P/ BOMBA DE INFUSAO ENTERAL / PARENT	20.2800	20.2775	0.0025	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	08435	EQUIPO P/ BOMBA DE INFUSAO ENTERAL / PARENT	20.2800	20.2775	0.0025	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	33219	LUVA DE PROCEDIMENTO UNIDADE UN	0.3300	0.0000	0.3300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	11193	CLOREXIDINA 2 % ST TP ML	0.5300	0.0000	0.5300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	33588	CLORETO DE SODIO 20% 10 ML SI IV AP	1.1000	1.1250	-0.0250	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	33545	PIPERACILINA 4 G + TAZOBACTAM 500 MG PO IV	83.4500	83.4500	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	6.8145	-3.4045	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	6.8145	-3.4045	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	6.8145	-3.4045	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	6.8145	-3.4045	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	6.8145	-3.4045	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	6.8145	-3.4045	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	6.8145	-3.4045	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4072	0.0028	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4072	0.0028	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4072	0.0028	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4072	0.0028	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4072	0.0028	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	33227	LUVA CIRURGICA PAR UN	2.9000	2.9000	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	33227	LUVA CIRURGICA PAR UN	2.9000	2.9000	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	33227	LUVA CIRURGICA PAR UN	2.9000	2.9000	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	33227	LUVA CIRURGICA PAR UN	2.9000	2.9000	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.2120	-0.1120	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.2120	-0.1120	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.2120	-0.1120	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.2120	-0.1120	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.2120	-0.1120	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	19160	SERINGA DESC 20 ML UN	0.5400	0.5374	0.0026	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	19160	SERINGA DESC 20 ML UN	0.5400	0.5374	0.0026	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	19160	SERINGA DESC 20 ML UN	0.5400	0.5374	0.0026	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	19160	SERINGA DESC 20 ML UN	0.5400	0.5374	0.0026	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00426	AGUA BIDESTILADA 10 ML SI IV IM AP	0.4000	0.4026	-0.0026	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00426	AGUA BIDESTILADA 10 ML SI IV IM AP	0.4000	0.4037	-0.0037	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00426	AGUA BIDESTILADA 10 ML SI IV IM AP	0.4000	0.4037	-0.0037	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00426	AGUA BIDESTILADA 10 ML SI IV IM AP	0.4000	0.4037	-0.0037	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00426	AGUA BIDESTILADA 10 ML SI IV IM AP	0.4000	0.4037	-0.0037	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00426	AGUA BIDESTILADA 10 ML SI IV IM AP	0.4000	0.4037	-0.0037	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00426	AGUA BIDESTILADA 10 ML SI IV IM AP	0.4000	0.4037	-0.0037	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00426	AGUA BIDESTILADA 10 ML SI IV IM AP	0.4000	0.4037	-0.0037	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00426	AGUA BIDESTILADA 10 ML SI IV IM AP	0.8100	0.8073	0.0027	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00426	AGUA BIDESTILADA 10 ML SI IV IM AP	0.8100	0.8073	0.0027	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00426	AGUA BIDESTILADA 10 ML SI IV IM AP	0.8100	0.8073	0.0027	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	13757	IODOPOVIDONA SD TP ML	0.4000	0.4000	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	13757	IODOPOVIDONA SD TP ML	0.4000	0.4000	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	33219	LUVA DE PROCEDIMENTO UNIDADE UN	1.3300	1.3400	-0.0100	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00434	AGUA BIDESTILADA 1000 ML SI IM IV BS	71.2000	80.1000	-71.2000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	09636	FLORATIL (SACCHAROMYCES BOULARDII) 200 MG P	4.4400	8.8851	-4.4451	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	09636	FLORATIL (SACCHAROMYCES BOULARDII) 200 MG P	4.4400	8.8851	-4.4451	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	05975	COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER	1.3439	1.3948	-0.7948	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	28959	DERSANI LC TP ML	12.6100	13.5800	-3.8800	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	08664	ESPARADRAPO MICROPORE 50 X 10 CM CM	1.3564	1.3849	-0.8749	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	08664	ESPARADRAPO MICROPORE 50 X 10 CM CM	1.8664	1.8979	-0.8779	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1d6bbb4a00130e2e654e830fc9bae6a	ALEXANDRINA	12694224940	NULL	12694224940	05274	AMOXICILINA 500 MG + CLAVULANATO 125 MG CP	3.1700	3.1667	0.0033	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	00123	LUVA CIRURGICA UN	NULL	0.0000	NULL	OPME INVALIDO	2201
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	00123	LUVA CIRURGICA UN	NULL	0.0000	NULL	OPME INVALIDO	2201
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	00123	LUVA CIRURGICA UN	NULL	0.0000	NULL	OPME INVALIDO	2201
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	52392	SONDA DE ASPIRAÇAO TRAQUEAL C/ VALVULA UN	NULL	0.0000	NULL	OPME INVALIDO	2201
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	52733	SERINGA DESC 20 ML UN	NULL	0.0000	NULL	OPME INVALIDO	2201
Glosa Min	2018-10-03 00:00:00.000000	1084117	800720d33fe0defb6121e82dd216d044	JALMO	12786952647	NULL	12786952647	00501	DRAMIN B6 DL (DIMENIDRINATO + PIRIDOXINA + GLIC.	0.0000	2.2100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	800720d33fe0defb6121e82dd216d044	JALMO	12786952647	NULL	12786952647	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.0000	0.8100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	800720d33fe0defb6121e82dd216d044	JALMO	12786952647	NULL	12786952647	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1800	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	800720d33fe0defb6121e82dd216d044	JALMO	12786952647	NULL	12786952647	00757	CEFUROXIMA 750 MG + DIL. 6 ML PO IM IV FA	0.0000	26.1300	NULL	VALOR APRESENTADO A MAIOR	1705
Glosa Min	2018-10-03 00:00:00.000000	1084117	800720d33fe0defb6121e82dd216d044	JALMO	12786952647	NULL	12786952647	00919	ALGODAO HIDROFILO BOLINHA UN	0.0000	0.1300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	752c651cb4fd049e19c685f87fbe8bdc	EDUARDO	12765990646	NULL	12765990646	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.2050	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	752c651cb4fd049e19c685f87fbe8bdc	EDUARDO	12765990646	NULL	12765990646	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.0000	0.6875	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	752c651cb4fd049e19c685f87fbe8bdc	EDUARDO	12765990646	NULL	12765990646	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.0000	0.6875	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	752c651cb4fd049e19c685f87fbe8bdc	EDUARDO	12765990646	NULL	12765990646	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.0000	0.6875	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	752c651cb4fd049e19c685f87fbe8bdc	EDUARDO	12765990646	NULL	12765990646	53975	Hemifumarato De Quetiapina 25mg ? Cp	0.0000	1.2500	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12558131243	NULL	12558131243	00128	LUVA DE PROCEDIMENTO UNIDADE UN	0.0000	1.0000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12558131243	NULL	12558131243	04259	DRENO DE SUCCAO	0.0000	0.0000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12558131243	NULL	12558131243	52010341	Hérnia Discal - Tratamento Cirúrgico	0.0000	0.0000	NULL	COBRANCA DE HONORARIOS EM DUPLICIDADE	2607
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12558131243	NULL	12558131243	52010341	Hérnia Discal - Tratamento Cirúrgico	0.0000	0.0000	NULL	COBRANCA DE HONORARIOS EM DUPLICIDADE	2607
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12558131243	NULL	12558131243	52010511	Fratura do Cóccix - Tratamento Cruento	0.0000	0.0000	NULL	COBRANCA DE HONORARIOS EM DUPLICIDADE	2607
Glosa Min	2018-10-03 00:00:00.000000	1084117	526685c1041cc1316e874a2e95e67e2e	JOSE	12696604949	NULL	12696604949	55060153	Toracotomia com Drenagem Fechada	0.0000	0.0000	NULL	COBRANCA DE HONORARIOS EM DUPLICIDADE	2607
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	102001	DIARIA DE APARTAMENTO	0.0000	2888.8800	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	11232	CLEXANE (ENOXAPARINA) 40 MG SI IV SC SE	0.0000	38.9400	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.0000	0.0000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.0000	0.0000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.0000	0.0000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.0000	0.0000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	51242	SONDA DOBBHOFF (P/ ALIMENTAÇÃO ENTERAL) UN	0.0000	38.8100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	51379	SERINGA DESC 05 ML UN	0.0000	0.1900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	51379	SERINGA DESC 05 ML UN	0.0000	0.1900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	51434	BECLOMETASONA 400 MCG / ML 2 ML SL IN FL	0.0000	4.4800	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	51660	BROMETO DE IPRATROPIO SL IN GT	0.0000	0.0000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00943	EQUIPO POLIFIX 2 VIAS UN	0.0000	5.1000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	51659	FENOTEROL 2 MG/ML 10 ML AE IN DS	0.0000	0.4300	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	4e13adf421809cb755e1bdd80cc4efed	AGRIPINA	12385409142	NULL	12385409142	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	4e13adf421809cb755e1bdd80cc4efed	AGRIPINA	12385409142	NULL	12385409142	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	4e13adf421809cb755e1bdd80cc4efed	AGRIPINA	12385409142	NULL	12385409142	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	4e13adf421809cb755e1bdd80cc4efed	AGRIPINA	12385409142	NULL	12385409142	00487	RANITIDINA 25 MG/ML 2 ML SI IM IV AP	0.0000	0.9300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	75bcd473a0dc7c7a6751499b38a4a034	JOAQUIM	12692852143	NULL	12692852143	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4075	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	75bcd473a0dc7c7a6751499b38a4a034	JOAQUIM	12692852143	NULL	12692852143	01652	TRAMADOL 50 MG CP VO UN	0.0000	1.9272	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	75bcd473a0dc7c7a6751499b38a4a034	JOAQUIM	12692852143	NULL	12692852143	01652	TRAMADOL 50 MG CP VO UN	0.0000	1.9272	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	75bcd473a0dc7c7a6751499b38a4a034	JOAQUIM	12692852143	NULL	12692852143	00172	SORO FISIOLOGICO 0,9% 500 ML SI IV BS	0.0000	4.7300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	75bcd473a0dc7c7a6751499b38a4a034	JOAQUIM	12692852143	NULL	12692852143	25030019	Distúrbios Circulatórios Artério - Venosos e Linfáticos	0.0000	45.8500	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	75bcd473a0dc7c7a6751499b38a4a034	JOAQUIM	12692852143	NULL	12692852143	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.0000	0.6900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	75bcd473a0dc7c7a6751499b38a4a034	JOAQUIM	12692852143	NULL	12692852143	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.0000	0.6850	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	75bcd473a0dc7c7a6751499b38a4a034	JOAQUIM	12692852143	NULL	12692852143	00404	LACTULOSE 667 MG/ML XP VO ML	0.0000	4.2900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	75bcd473a0dc7c7a6751499b38a4a034	JOAQUIM	12692852143	NULL	12692852143	04073	TRAMADOL 50 MG 1 ML SI IM IV AP	0.0000	4.1900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	75bcd473a0dc7c7a6751499b38a4a034	JOAQUIM	12692852143	NULL	12692852143	04073	TRAMADOL 50 MG 1 ML SI IM IV AP	0.0000	4.1900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	75bcd473a0dc7c7a6751499b38a4a034	JOAQUIM	12692852143	NULL	12692852143	51710	CLORETO DE POTASSIO 15% 10 ML SI IV AP	0.0000	0.6850	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00124	LUVA CIRURGICA UN	0.0000	1.4475	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00124	LUVA CIRURGICA UN	0.0000	1.4475	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00124	LUVA CIRURGICA UN	0.0000	1.4475	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	24082	BROMOPRIDA 5 MG/ML 2 ML SI IM IV AP	0.0000	2.7300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	26981	SORO FISIOLOGICO 0,9% 10 ML SI IV AP	0.0000	0.9600	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.0000	0.6875	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.0000	0.6900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00487	RANITIDINA 25 MG/ML 2 ML SI IM IV AP	0.0000	0.9300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	54756	HIDANTAL	0.0000	0.1864	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	54756	HIDANTAL	0.0000	0.1864	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	55795	FOSFATO DE POTASSIO 2 MEQ/ML 10 ML SI IV AP	0.0000	3.0200	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00796	FLORATIL (SACCHAROMYCES BOULARDII) 200 MG PO VO	0.0000	4.4400	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00796	FLORATIL (SACCHAROMYCES BOULARDII) 200 MG PO VO	0.0000	4.4400	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4088	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4088	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4088	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4088	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4088	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4088	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.0000	0.6872	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.0000	0.6872	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1800	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1766	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.0000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1766	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1766	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1766	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1766	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1766	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1766	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	00170	SORO GLICOSADO 5% 250 ML SI IV BS	0.0000	6.7800	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	22421	PIPERACILINA 2 G + TAZOBACTAM 250 MG 30 ML PO IV	0.0000	55.3400	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	22421	PIPERACILINA 2 G + TAZOBACTAM 250 MG 30 ML PO IV	0.0000	55.3400	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	22421	PIPERACILINA 2 G + TAZOBACTAM 250 MG 30 ML PO IV	0.0000	55.3400	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	22421	PIPERACILINA 2 G + TAZOBACTAM 250 MG 30 ML PO IV	0.0000	55.3400	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	22421	PIPERACILINA 2 G + TAZOBACTAM 250 MG 30 ML PO IV	0.0000	55.3400	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	COBRANCA DE TAXAS, DE SERVICOS REALIZADOS EM AMBIENTES INCOMPATIVEIS COM O USO DE EQUIPAMENTOS	2407
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	35382	COMPRESSAS DE GASES 7.5 X7,5 (11 FIOS ESTERIL) UN	0.0000	0.3000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	51508	ENCRISE (ARGIPRESSINA) 20 U/ML 1 ML SI IM IV SC AP	0.0000	20.1200	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	51584	ESPARADRAPO MICROPORE	0.0000	0.2560	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	52303	NOREPINEFRINA 2 MG/ML 4 ML SI IV AP	0.0000	218.4200	NULL	VALOR APRESENTADO A MAIOR	1705
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	52976	FIO MONONYLON 3-0 C/ AGULHA 2,4 3/8 163T EV	0.0000	4.2581	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	cd2840524be5a3f1d0939f241e24f32b	MARIA	12705908340	NULL	12705908340	00181	SULFATO DE MAGNESIO 100 MG/ML 10 ML SI IM IV	0.0000	0.9467	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	cd2840524be5a3f1d0939f241e24f32b	MARIA	12705908340	NULL	12705908340	00184	CLORETO DE POTASSIO 10% 10 ML SI IV AP	0.0000	0.2967	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	cd2840524be5a3f1d0939f241e24f32b	MARIA	12705908340	NULL	12705908340	00184	CLORETO DE POTASSIO 10% 10 ML SI IV AP	0.0000	0.2967	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	cd2840524be5a3f1d0939f241e24f32b	MARIA	12705908340	NULL	12705908340	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	cd2840524be5a3f1d0939f241e24f32b	MARIA	12705908340	NULL	12705908340	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	cd2840524be5a3f1d0939f241e24f32b	MARIA	12705908340	NULL	12705908340	00090	SERINGA DESC 20 ML UN	0.0000	0.5367	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	cd2840524be5a3f1d0939f241e24f32b	MARIA	12705908340	NULL	12705908340	00090	SERINGA DESC 20 ML UN	0.0000	0.5367	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12550571048	NULL	12550571048	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1775	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12550571048	NULL	12550571048	51660	BROMETO DE IPRATROPIO SL IN GT	0.0000	3.0000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12550571048	NULL	12550571048	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12550571048	NULL	12550571048	00090	SERINGA DESC 20 ML UN	0.0000	0.5379	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	9ffbbf7340bbd65e9e3baa9406d027f3	MARCO	12261811645	NULL	12261811645	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	9ffbbf7340bbd65e9e3baa9406d027f3	MARCO	12261811645	NULL	12261811645	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	9ffbbf7340bbd65e9e3baa9406d027f3	MARCO	12261811645	NULL	12261811645	01611	CLORETO DE POTASSIO 600 MG CA VO UN	0.0000	0.4867	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	9ffbbf7340bbd65e9e3baa9406d027f3	MARCO	12261811645	NULL	12261811645	20010150	Ecodoppler de Esforço ou Stress Farmacológico	0.0000	0.0000	NULL	EXAME NAO AUTORIZADO	2707
Glosa Min	2018-10-03 00:00:00.000000	1084117	9ffbbf7340bbd65e9e3baa9406d027f3	MARCO	12261811645	NULL	12261811645	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.0000	0.8078	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	9ffbbf7340bbd65e9e3baa9406d027f3	MARCO	12261811645	NULL	12261811645	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1773	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	9ffbbf7340bbd65e9e3baa9406d027f3	MARCO	12261811645	NULL	12261811645	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1773	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	9ffbbf7340bbd65e9e3baa9406d027f3	MARCO	12261811645	NULL	12261811645	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1773	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	9ffbbf7340bbd65e9e3baa9406d027f3	MARCO	12261811645	NULL	12261811645	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1773	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	9ffbbf7340bbd65e9e3baa9406d027f3	MARCO	12261811645	NULL	12261811645	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1773	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	9ffbbf7340bbd65e9e3baa9406d027f3	MARCO	12261811645	NULL	12261811645	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1800	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4094	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4094	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4094	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	01496	FENITOINA 50 MG/ML 5 ML SI IM IV AP	0.0000	2.3400	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	01496	FENITOINA 50 MG/ML 5 ML SI IM IV AP	0.0000	2.3400	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	01496	FENITOINA 50 MG/ML 5 ML SI IM IV AP	0.0000	2.3400	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	01496	FENITOINA 50 MG/ML 5 ML SI IM IV AP	0.0000	2.3400	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	02246	HIDROCORTISONA 100 MG PO IM IV FA	0.0000	2.8300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	02246	HIDROCORTISONA 100 MG PO IM IV FA	0.0000	2.8300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	26981	SORO FISIOLOGICO 0,9% 10 ML SI IV AP	0.0000	0.4800	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	26981	SORO FISIOLOGICO 0,9% 10 ML SI IV AP	0.0000	0.4800	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	26981	SORO FISIOLOGICO 0,9% 10 ML SI IV AP	0.0000	0.4800	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	26981	SORO FISIOLOGICO 0,9% 10 ML SI IV AP	0.0000	0.4800	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	26981	SORO FISIOLOGICO 0,9% 10 ML SI IV AP	0.0000	0.9600	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	26981	SORO FISIOLOGICO 0,9% 10 ML SI IV AP	0.0000	0.9600	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	26981	SORO FISIOLOGICO 0,9% 10 ML SI IV AP	0.0000	0.9600	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	26981	SORO FISIOLOGICO 0,9% 10 ML SI IV AP	0.0000	0.9600	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	26981	SORO FISIOLOGICO 0,9% 10 ML SI IV AP	0.0000	0.9600	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	26981	SORO FISIOLOGICO 0,9% 10 ML SI IV AP	0.0000	0.9600	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	52392	SONDA DE ASPIRAÇAO TRAQUEAL C/ VALVULA UN	0.0000	0.9352	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	00069	SERINGA DESC 10 ML UN	0.0000	0.0000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	15f461c0ca379f375bd9f8b18fbb101a	ANA	12753753845	NULL	12753753845	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR APRESENTADO A MAIOR	1705
Glosa Min	2018-10-03 00:00:00.000000	1084117	15f461c0ca379f375bd9f8b18fbb101a	ANA	12753753845	NULL	12753753845	00657	CEFAZOLINA 1 GR + DIL. 10 ML PO IM IV FA	0.0000	8.1300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	11700	EQUIPO P/ BOMBA DE INFUSAO ENTERAL / PARENTERAL	0.0000	0.0000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00124	LUVA CIRURGICA UN	0.0000	1.4475	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00124	LUVA CIRURGICA UN	0.0000	1.4475	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4072	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4072	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4072	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4072	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4072	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4072	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4072	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4072	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4072	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4072	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4072	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4072	NULL	COBRANCA DE MEDICAMENTO EM QUANTIDADE INCOMPATIVEL COM A PERMANENCIA	2107
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4072	NULL	VALOR APRESENTADO A MAIOR	1705
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4072	NULL	VALOR APRESENTADO A MAIOR	1705
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4072	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4072	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4072	NULL	VALOR APRESENTADO A MAIOR	1705
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4072	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	01611	CLORETO DE POTASSIO 600 MG CA VO UN	0.0000	0.4870	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	01611	CLORETO DE POTASSIO 600 MG CA VO UN	0.0000	0.4870	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	01611	CLORETO DE POTASSIO 600 MG CA VO UN	0.0000	0.4870	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	02355	AMOXICILINA 1 G + CLAVULANATO 200 MG + DIL. 10 ML	0.0000	36.4657	NULL	COBRANCA DE MEDICAMENTO EM QUANTIDADE INCOMPATIVEL COM A PERMANENCIA	2107
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	02355	AMOXICILINA 1 G + CLAVULANATO 200 MG + DIL. 10 ML	0.0000	36.4667	NULL	COBRANCA DE MEDICAMENTO EM QUANTIDADE INCOMPATIVEL COM A PERMANENCIA	2107
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	02355	AMOXICILINA 1 G + CLAVULANATO 200 MG + DIL. 10 ML	0.0000	36.4667	NULL	COBRANCA DE MEDICAMENTO EM QUANTIDADE INCOMPATIVEL COM A PERMANENCIA	2107
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	02355	AMOXICILINA 1 G + CLAVULANATO 200 MG + DIL. 10 ML	0.0000	36.4667	NULL	COBRANCA DE MEDICAMENTO EM QUANTIDADE INCOMPATIVEL COM A PERMANENCIA	2107
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	02355	AMOXICILINA 1 G + CLAVULANATO 200 MG + DIL. 10 ML	0.0000	36.4667	NULL	COBRANCA DE MEDICAMENTO EM QUANTIDADE INCOMPATIVEL COM A PERMANENCIA	2107
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	02355	AMOXICILINA 1 G + CLAVULANATO 200 MG + DIL. 10 ML	0.0000	36.4667	NULL	COBRANCA DE MEDICAMENTO EM QUANTIDADE INCOMPATIVEL COM A PERMANENCIA	2107
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	02355	AMOXICILINA 1 G + CLAVULANATO 200 MG + DIL. 10 ML	0.0000	36.4667	NULL	COBRANCA DE MEDICAMENTO EM QUANTIDADE INCOMPATIVEL COM A PERMANENCIA	2107
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00090	SERINGA DESC 20 ML UN	0.0000	0.5367	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00090	SERINGA DESC 20 ML UN	0.0000	0.5367	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00090	SERINGA DESC 20 ML UN	0.0000	0.5367	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00090	SERINGA DESC 20 ML UN	0.0000	0.5367	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00090	SERINGA DESC 20 ML UN	0.0000	0.5367	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00090	SERINGA DESC 20 ML UN	0.0000	1.0733	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00090	SERINGA DESC 20 ML UN	0.0000	1.0733	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	2e6b6f291f2df9beb1fbda6028678909	ANNA	12463693448	NULL	12463693448	09070	ACETILCISTEINA 600MG PO VO SA	0.0000	3.5000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	11325	EQUIPO MACRO-GOTAS FLEXIVEL C/ INJETOR LATERAL UN	0.0000	1.5900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00124	LUVA CIRURGICA UN	0.0000	1.4478	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00124	LUVA CIRURGICA UN	0.0000	1.4478	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.0000	0.6871	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.0000	0.6871	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.0000	0.6871	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.0000	0.6871	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	35382	COMPRESSAS DE GASES 7.5 X7,5 (11 FIOS ESTERIL) UN	0.0000	0.3000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00037	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00487	RANITIDINA 25 MG/ML 2 ML SI IM IV AP	0.0000	0.9300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00487	RANITIDINA 25 MG/ML 2 ML SI IM IV AP	0.0000	1.8700	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.0000	0.4000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.0000	0.4000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.0000	0.4000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.0000	0.4000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1776	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	51649	ALCOOL ETILICO 70 % ST TP ML	0.0000	0.0200	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00090	SERINGA DESC 20 ML UN	0.0000	0.5375	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00090	SERINGA DESC 20 ML UN	0.0000	0.5375	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00090	SERINGA DESC 20 ML UN	0.0000	0.5375	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00090	SERINGA DESC 20 ML UN	0.0000	0.5375	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00090	SERINGA DESC 20 ML UN	0.0000	0.5375	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00090	SERINGA DESC 20 ML UN	0.0000	0.5375	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00090	SERINGA DESC 20 ML UN	0.0000	0.5375	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00090	SERINGA DESC 20 ML UN	0.0000	0.5375	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00090	SERINGA DESC 20 ML UN	0.0000	0.5400	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00090	SERINGA DESC 20 ML UN	0.0000	0.5375	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00090	SERINGA DESC 20 ML UN	0.0000	0.5375	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00090	SERINGA DESC 20 ML UN	0.0000	0.5375	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00098	ABOCATH N 14 A 22 UN	0.0000	3.7660	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00098	ABOCATH N 14 A 22 UN	0.0000	3.7660	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	ea4ad2636c25d8e3dbb569ae62db71e7	IONE	12489788840	NULL	12489788840	20010141	Ecocardiograma Bidimensional com Mapeamento de Fluxo à Cores	0.0000	0.0000	NULL	EXAME SEM REGISTRO DE EXECUCAO	2703
Glosa Min	2018-10-03 00:00:00.000000	1084117	ea4ad2636c25d8e3dbb569ae62db71e7	IONE	12489788840	NULL	12489788840	25040014	Fisioterapia Respiratória - em Doente Clínico Internado	0.0000	10.0600	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1965b0cdebe9017c3397c8641147759	JOSE	12705413746	NULL	12705413746	25030019	Distúrbios Circulatórios Artério - Venosos e Linfáticos	0.0000	57.3200	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1965b0cdebe9017c3397c8641147759	JOSE	12705413746	NULL	12705413746	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1965b0cdebe9017c3397c8641147759	JOSE	12705413746	NULL	12705413746	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.0000	0.6900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1965b0cdebe9017c3397c8641147759	JOSE	12705413746	NULL	12705413746	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.0000	0.8088	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1965b0cdebe9017c3397c8641147759	JOSE	12705413746	NULL	12705413746	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.0000	0.8074	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1965b0cdebe9017c3397c8641147759	JOSE	12705413746	NULL	12705413746	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.0000	0.8074	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1965b0cdebe9017c3397c8641147759	JOSE	12705413746	NULL	12705413746	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.0000	0.8074	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1965b0cdebe9017c3397c8641147759	JOSE	12705413746	NULL	12705413746	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.0000	0.8074	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1965b0cdebe9017c3397c8641147759	JOSE	12705413746	NULL	12705413746	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.0000	0.8074	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1965b0cdebe9017c3397c8641147759	JOSE	12705413746	NULL	12705413746	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.0000	0.8074	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1965b0cdebe9017c3397c8641147759	JOSE	12705413746	NULL	12705413746	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.0000	0.8074	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1965b0cdebe9017c3397c8641147759	JOSE	12705413746	NULL	12705413746	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1775	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1965b0cdebe9017c3397c8641147759	JOSE	12705413746	NULL	12705413746	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1775	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1965b0cdebe9017c3397c8641147759	JOSE	12705413746	NULL	12705413746	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1775	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1965b0cdebe9017c3397c8641147759	JOSE	12705413746	NULL	12705413746	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1775	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1965b0cdebe9017c3397c8641147759	JOSE	12705413746	NULL	12705413746	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1775	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1965b0cdebe9017c3397c8641147759	JOSE	12705413746	NULL	12705413746	51584	ESPARADRAPO MICROPORE	0.0000	0.3800	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1965b0cdebe9017c3397c8641147759	JOSE	12705413746	NULL	12705413746	51584	ESPARADRAPO MICROPORE	0.0000	0.3800	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1965b0cdebe9017c3397c8641147759	JOSE	12705413746	NULL	12705413746	51671	REPARIL (ESCINA + DIETILAMONIO) GL TP GR	0.0000	0.0000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1965b0cdebe9017c3397c8641147759	JOSE	12705413746	NULL	12705413746	54995	EQUIPO P/ BOMBA DE INFUSAO ENTERAL / PARENTERAL U UN	0.0000	0.0000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1965b0cdebe9017c3397c8641147759	JOSE	12705413746	NULL	12705413746	00090	SERINGA DESC 20 ML UN	0.0000	0.5375	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1965b0cdebe9017c3397c8641147759	JOSE	12705413746	NULL	12705413746	00090	SERINGA DESC 20 ML UN	0.0000	0.5375	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1965b0cdebe9017c3397c8641147759	JOSE	12705413746	NULL	12705413746	00090	SERINGA DESC 20 ML UN	0.0000	0.5375	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1965b0cdebe9017c3397c8641147759	JOSE	12705413746	NULL	12705413746	00090	SERINGA DESC 20 ML UN	0.0000	0.5375	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1965b0cdebe9017c3397c8641147759	JOSE	12705413746	NULL	12705413746	00090	SERINGA DESC 20 ML UN	0.0000	0.5375	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1965b0cdebe9017c3397c8641147759	JOSE	12705413746	NULL	12705413746	00090	SERINGA DESC 20 ML UN	0.0000	0.5375	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1965b0cdebe9017c3397c8641147759	JOSE	12705413746	NULL	12705413746	00090	SERINGA DESC 20 ML UN	0.0000	0.5375	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	dd6f8d6c53ffe9bfd3aa9590ba500cc8	ILDA	12751932542	NULL	12751932542	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.0000	0.8080	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	dd6f8d6c53ffe9bfd3aa9590ba500cc8	ILDA	12751932542	NULL	12751932542	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.7000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a39fe8b0276da428395df4da4f2b1537	JOSE	12442708440	NULL	12442708440	00128	LUVA DE PROCEDIMENTO UNIDADE UN	0.0000	0.9987	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a39fe8b0276da428395df4da4f2b1537	JOSE	12442708440	NULL	12442708440	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a39fe8b0276da428395df4da4f2b1537	JOSE	12442708440	NULL	12442708440	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a39fe8b0276da428395df4da4f2b1537	JOSE	12442708440	NULL	12442708440	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a39fe8b0276da428395df4da4f2b1537	JOSE	12442708440	NULL	12442708440	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a39fe8b0276da428395df4da4f2b1537	JOSE	12442708440	NULL	12442708440	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a39fe8b0276da428395df4da4f2b1537	JOSE	12442708440	NULL	12442708440	01691	NISTATINA 100.000 UI/ML SU VO ML	0.0000	0.2950	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a39fe8b0276da428395df4da4f2b1537	JOSE	12442708440	NULL	12442708440	01691	NISTATINA 100.000 UI/ML SU VO ML	0.0000	0.2950	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a39fe8b0276da428395df4da4f2b1537	JOSE	12442708440	NULL	12442708440	26981	SORO FISIOLOGICO 0,9% 10 ML SI IV AP	0.0000	0.1400	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a39fe8b0276da428395df4da4f2b1537	JOSE	12442708440	NULL	12442708440	26981	SORO FISIOLOGICO 0,9% 10 ML SI IV AP	0.0000	0.1400	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a39fe8b0276da428395df4da4f2b1537	JOSE	12442708440	NULL	12442708440	26981	SORO FISIOLOGICO 0,9% 10 ML SI IV AP	0.0000	0.1400	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a39fe8b0276da428395df4da4f2b1537	JOSE	12442708440	NULL	12442708440	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1765	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a39fe8b0276da428395df4da4f2b1537	JOSE	12442708440	NULL	12442708440	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1765	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a39fe8b0276da428395df4da4f2b1537	JOSE	12442708440	NULL	12442708440	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1765	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a39fe8b0276da428395df4da4f2b1537	JOSE	12442708440	NULL	12442708440	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1765	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a39fe8b0276da428395df4da4f2b1537	JOSE	12442708440	NULL	12442708440	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1765	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a39fe8b0276da428395df4da4f2b1537	JOSE	12442708440	NULL	12442708440	51241	AGULHA 123X45	0.0000	0.1900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a39fe8b0276da428395df4da4f2b1537	JOSE	12442708440	NULL	12442708440	51241	AGULHA 123X45	0.0000	0.1900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a39fe8b0276da428395df4da4f2b1537	JOSE	12442708440	NULL	12442708440	00090	SERINGA DESC 20 ML UN	0.0000	0.5373	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a39fe8b0276da428395df4da4f2b1537	JOSE	12442708440	NULL	12442708440	00090	SERINGA DESC 20 ML UN	0.0000	0.5373	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	61e4786d45edfdbf19b77fb2c6ce6b9c	REINALDO	12754482747	NULL	12754482747	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	61e4786d45edfdbf19b77fb2c6ce6b9c	REINALDO	12754482747	NULL	12754482747	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	61e4786d45edfdbf19b77fb2c6ce6b9c	REINALDO	12754482747	NULL	12754482747	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	61e4786d45edfdbf19b77fb2c6ce6b9c	REINALDO	12754482747	NULL	12754482747	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	61e4786d45edfdbf19b77fb2c6ce6b9c	REINALDO	12754482747	NULL	12754482747	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	61e4786d45edfdbf19b77fb2c6ce6b9c	REINALDO	12754482747	NULL	12754482747	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	61e4786d45edfdbf19b77fb2c6ce6b9c	REINALDO	12754482747	NULL	12754482747	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	61e4786d45edfdbf19b77fb2c6ce6b9c	REINALDO	12754482747	NULL	12754482747	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	61e4786d45edfdbf19b77fb2c6ce6b9c	REINALDO	12754482747	NULL	12754482747	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	61e4786d45edfdbf19b77fb2c6ce6b9c	REINALDO	12754482747	NULL	12754482747	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	61e4786d45edfdbf19b77fb2c6ce6b9c	REINALDO	12754482747	NULL	12754482747	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.0000	0.6900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	61e4786d45edfdbf19b77fb2c6ce6b9c	REINALDO	12754482747	NULL	12754482747	51589	ESPARADRAPO 10 X 4.5 CM CM	0.0000	0.4000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	61e4786d45edfdbf19b77fb2c6ce6b9c	REINALDO	12754482747	NULL	12754482747	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	61e4786d45edfdbf19b77fb2c6ce6b9c	REINALDO	12754482747	NULL	12754482747	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	61e4786d45edfdbf19b77fb2c6ce6b9c	REINALDO	12754482747	NULL	12754482747	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	61e4786d45edfdbf19b77fb2c6ce6b9c	REINALDO	12754482747	NULL	12754482747	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	61e4786d45edfdbf19b77fb2c6ce6b9c	REINALDO	12754482747	NULL	12754482747	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4072	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4072	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4072	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4072	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4072	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	00090	SERINGA DESC 20 ML UN	0.0000	0.5371	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	00090	SERINGA DESC 20 ML UN	0.0000	0.5371	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	00090	SERINGA DESC 20 ML UN	0.0000	0.5371	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	00090	SERINGA DESC 20 ML UN	0.0000	0.5371	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	00090	SERINGA DESC 20 ML UN	0.0000	0.5371	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	00090	SERINGA DESC 20 ML UN	0.0000	0.5371	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	00090	SERINGA DESC 20 ML UN	0.0000	0.5371	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	00090	SERINGA DESC 20 ML UN	0.0000	0.5371	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	00090	SERINGA DESC 20 ML UN	0.0000	0.5371	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	00090	SERINGA DESC 20 ML UN	0.0000	0.5371	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	00090	SERINGA DESC 20 ML UN	0.0000	0.5371	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	00090	SERINGA DESC 20 ML UN	0.0000	0.5371	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	081fdadb830fb547e83c43fabdb88372	ELZA	12377335349	NULL	12377335349	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	081fdadb830fb547e83c43fabdb88372	ELZA	12377335349	NULL	12377335349	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	081fdadb830fb547e83c43fabdb88372	ELZA	12377335349	NULL	12377335349	01611	CLORETO DE POTASSIO 600 MG CA VO UN	0.0000	0.4900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	081fdadb830fb547e83c43fabdb88372	ELZA	12377335349	NULL	12377335349	01611	CLORETO DE POTASSIO 600 MG CA VO UN	0.0000	0.4900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	081fdadb830fb547e83c43fabdb88372	ELZA	12377335349	NULL	12377335349	01611	CLORETO DE POTASSIO 600 MG CA VO UN	0.0000	0.4900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	081fdadb830fb547e83c43fabdb88372	ELZA	12377335349	NULL	12377335349	02246	HIDROCORTISONA 100 MG PO IM IV FA	0.0000	5.6700	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	081fdadb830fb547e83c43fabdb88372	ELZA	12377335349	NULL	12377335349	02246	HIDROCORTISONA 100 MG PO IM IV FA	0.0000	5.6700	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	081fdadb830fb547e83c43fabdb88372	ELZA	12377335349	NULL	12377335349	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1800	NULL	PAGO CONFORME RELATORIO DE AUDITORIA EXTERNA ― CONTA INICIAL	1717
Glosa Min	2018-10-03 00:00:00.000000	1084117	081fdadb830fb547e83c43fabdb88372	ELZA	12377335349	NULL	12377335349	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1800	NULL	PAGO CONFORME RELATORIO DE AUDITORIA EXTERNA ― CONTA INICIAL	1717
Glosa Min	2018-10-03 00:00:00.000000	1084117	081fdadb830fb547e83c43fabdb88372	ELZA	12377335349	NULL	12377335349	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1800	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	081fdadb830fb547e83c43fabdb88372	ELZA	12377335349	NULL	12377335349	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1800	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	081fdadb830fb547e83c43fabdb88372	ELZA	12377335349	NULL	12377335349	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1800	NULL	PAGO CONFORME RELATORIO DE AUDITORIA EXTERNA ― CONTA INICIAL	1717
Glosa Min	2018-10-03 00:00:00.000000	1084117	081fdadb830fb547e83c43fabdb88372	ELZA	12377335349	NULL	12377335349	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1800	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	081fdadb830fb547e83c43fabdb88372	ELZA	12377335349	NULL	12377335349	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1800	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	35382	COMPRESSAS DE GASES 7.5 X7,5 (11 FIOS ESTERIL) UN	0.0000	0.6000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	51379	SERINGA DESC 05 ML UN	0.0000	0.1900	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	51379	SERINGA DESC 05 ML UN	0.0000	0.1900	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	51379	SERINGA DESC 05 ML UN	0.0000	0.1900	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	345c226bfea274af1372d41b0305a6c8	ALTINO	12720257940	NULL	12720257940	00493	BROMOPRIDA 5 MG/ML 2 ML SI IM IV AP	0.0000	2.7300	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	345c226bfea274af1372d41b0305a6c8	ALTINO	12720257940	NULL	12720257940	00090	SERINGA DESC 20 ML UN	0.0000	0.5367	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	dd486d36a88cfef0b44fe652638a0164	DELFINA	12660326244	NULL	12660326244	00128	LUVA DE PROCEDIMENTO UNIDADE UN	0.0000	1.6700	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	dd486d36a88cfef0b44fe652638a0164	DELFINA	12660326244	NULL	12660326244	00090	SERINGA DESC 20 ML UN	0.0000	0.5400	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	dd486d36a88cfef0b44fe652638a0164	DELFINA	12660326244	NULL	12660326244	00090	SERINGA DESC 20 ML UN	0.0000	0.5400	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	dd486d36a88cfef0b44fe652638a0164	DELFINA	12660326244	NULL	12660326244	00919	ALGODAO HIDROFILO BOLINHA UN	0.0000	0.2600	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	dd486d36a88cfef0b44fe652638a0164	DELFINA	12660326244	NULL	12660326244	00919	ALGODAO HIDROFILO BOLINHA UN	0.0000	0.2600	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	01652	TRAMADOL 50 MG CP VO UN	0.0000	1.9300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	01652	TRAMADOL 50 MG CP VO UN	0.0000	1.9300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	01652	TRAMADOL 50 MG CP VO UN	0.0000	1.9300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	01652	TRAMADOL 50 MG CP VO UN	0.0000	1.9300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.0000	0.6900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.0000	0.6875	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.0000	0.6900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.0000	0.6900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.0000	0.6900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.0000	0.6900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.0000	0.8100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1800	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1800	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	51589	ESPARADRAPO 10 X 4.5 CM CM	0.0000	0.4000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3fb5c891f31bb9efcb05395066127c52	ALAIDE	12636273441	NULL	12636273441	00487	RANITIDINA 25 MG/ML 2 ML SI IM IV AP	0.0000	0.0000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	610c198ec4c064687cf0524f147d3aed	ROBERTO	12748814743	NULL	12748814743	16322	BENZILPENICILINA POTASSICA CRIST. 5.000.000	8.0700	8.0683	0.0017	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	610c198ec4c064687cf0524f147d3aed	ROBERTO	12748814743	NULL	12748814743	16322	BENZILPENICILINA POTASSICA CRIST. 5.000.000	8.0700	8.0683	0.0017	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	54989	LUFTAL (SIMETICONA) EM VO GT	0.0900	0.0400	0.0500	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	54989	LUFTAL (SIMETICONA) EM VO GT	0.1200	0.0500	0.0700	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	54989	LUFTAL (SIMETICONA) EM VO GT	0.1200	0.0500	0.0700	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00204	AAS (ACIDO ACETILSALICILICO) 100 MG CP VO UN	0.1400	0.0600	0.0800	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	51378	SERINGA DESC 03 ML UN	0.1500	0.0600	0.0900	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	51378	SERINGA DESC 03 ML UN	0.1500	0.0600	0.0900	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.4000	0.1600	0.2400	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.4000	0.1600	0.2400	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.4000	0.1600	0.2400	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.4000	0.1600	0.2400	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.4000	0.1600	0.2400	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.4000	0.1600	0.2400	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	51589	ESPARADRAPO 10 X 4.5 CM CM	0.4000	0.1600	0.2400	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	51589	ESPARADRAPO 10 X 4.5 CM CM	0.4000	0.1600	0.2400	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	54687	IODOPOVIDONA SD TP ML	0.4000	0.1600	0.2400	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	54687	IODOPOVIDONA SD TP ML	0.4000	0.1600	0.2400	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	07802	PIPERACILINA 4 G + TAZOBACTAM 500 MG PO IV FA	83.4500	32.5900	50.8600	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	07802	PIPERACILINA 4 G + TAZOBACTAM 500 MG PO IV FA	83.4500	32.5900	50.8600	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	54178	DIETA SEMI ELEMENTAR C/ IMUNOMODDULADORES 1.5 KCA	115.2000	44.9800	70.2200	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	54178	DIETA SEMI ELEMENTAR C/ IMUNOMODDULADORES 1.5 KCA	115.2000	44.9800	70.2200	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	01081197	edcdbaa61bbaa91565bc29f993979fda	JOHN	12767485129	NULL	12767485129	201001	TAXA DE SALA PORTE 0	NULL	0.0000	NULL	OPME INVALIDO	2201
Glosa Min	2018-10-03 00:00:00.000000	01081197	2d09719942c3ab57ad7a3a3de0808ecf	DEGNES	12660187820	NULL	12660187820	201001	TAXA DE SALA PORTE 0	NULL	0.0000	NULL	OPME INVALIDO	2201
Glosa Min	2018-10-03 00:00:00.000000	01081197	3af14fcc4f764a77ed38b3d2e81bcc76	JOAO	12687535922	NULL	12687535922	00171	SORO FISIOLOGICO 0,9% 250 ML SI IV BS	NULL	0.0000	NULL	OPME INVALIDO	2201
Glosa Min	2018-10-03 00:00:00.000000	1084117	16b1e9f62f247f02ad5cac910ee15b4e	BERCHOLINA	12631612848	NULL	12631612848	00171	SORO FISIOLOGICO 0,9% 250 ML SI IV BS	3.9400	3.7600	0.1800	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	16b1e9f62f247f02ad5cac910ee15b4e	BERCHOLINA	12631612848	NULL	12631612848	00171	SORO FISIOLOGICO 0,9% 250 ML SI IV BS	3.9400	3.7600	0.1800	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	16b1e9f62f247f02ad5cac910ee15b4e	BERCHOLINA	12631612848	NULL	12631612848	04073	TRAMADOL 50 MG 1 ML SI IM IV AP	4.1900	4.0000	0.1900	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	16b1e9f62f247f02ad5cac910ee15b4e	BERCHOLINA	12631612848	NULL	12631612848	04073	TRAMADOL 50 MG 1 ML SI IM IV AP	4.1900	3.9900	0.2000	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	16b1e9f62f247f02ad5cac910ee15b4e	BERCHOLINA	12631612848	NULL	12631612848	22421	PIPERACILINA 2 G + TAZOBACTAM 250 MG 30 ML PO IV	55.3400	52.7400	2.6000	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	16b1e9f62f247f02ad5cac910ee15b4e	BERCHOLINA	12631612848	NULL	12631612848	22421	PIPERACILINA 2 G + TAZOBACTAM 250 MG 30 ML PO IV	55.3400	52.7400	2.6000	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	16b1e9f62f247f02ad5cac910ee15b4e	BERCHOLINA	12631612848	NULL	12631612848	22421	PIPERACILINA 2 G + TAZOBACTAM 250 MG 30 ML PO IV	55.3400	52.7400	2.6000	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	01081195	dd5df5cadc0eeb82bb12177ef8c7398c	MARIA	12786762615	NULL	12786762615	00010014	CONSULTA EM CONSULTORIO MEDICO	0.0000	50.0000	NULL	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	01081195	fd1931b243a9f689cf3f934c698785ac	ADRIANA	12760902918	NULL	12760902918	00010014	CONSULTA EM CONSULTORIO MEDICO	0.0000	0.0000	50.0000	GUIA DE CONSULTA NAO EXECUTADA	0622
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12579183644	NULL	12579183644	00817	ALGODAO HIDROFILO BOLINHA UN	0.5100	0.2600	0.2500	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12579183644	NULL	12579183644	37761	ALCOOL ETILICO 70 % ST TP ML	0.0600	0.0300	0.0300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12579183644	NULL	12579183644	00817	ALGODAO HIDROFILO BOLINHA UN	0.5100	0.2600	0.2500	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12579183644	NULL	12579183644	00485	AGUA BIDESTILADA 500 ML SI IM IV BS	6.4300	0.0000	6.4300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12579183644	NULL	12579183644	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.0000	0.1000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12579183644	NULL	12579183644	02720	BOLSA COLETORA (SISTEMA ABERTO) UN	1.2800	0.6400	0.6400	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	d17b3c5ae418d82694895a326dee545a	ODILIA	12670516743	NULL	12670516743	33219	LUVA DE PROCEDIMENTO UNIDADE UN	1.0000	0.6700	0.3300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	d17b3c5ae418d82694895a326dee545a	ODILIA	12670516743	NULL	12670516743	37761	ALCOOL ETILICO 70 % ST TP ML	0.0300	0.0200	0.0100	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	d17b3c5ae418d82694895a326dee545a	ODILIA	12670516743	NULL	12670516743	02461	FENOTEROL 2 MG/ML 10 ML AE IN DS	0.6000	0.0000	0.6000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	d17b3c5ae418d82694895a326dee545a	ODILIA	12670516743	NULL	12670516743	02461	FENOTEROL 2 MG/ML 10 ML AE IN DS	0.0900	0.0000	0.0900	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	d17b3c5ae418d82694895a326dee545a	ODILIA	12670516743	NULL	12670516743	33219	LUVA DE PROCEDIMENTO UNIDADE UN	1.0000	0.6700	0.3300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	20cbe2e07b1dcd2b6af609a50df7ae80	LUCELENA	12690767849	NULL	12690767849	33219	LUVA DE PROCEDIMENTO UNIDADE UN	1.0000	0.6700	0.3300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	20cbe2e07b1dcd2b6af609a50df7ae80	LUCELENA	12690767849	NULL	12690767849	00817	ALGODAO HIDROFILO BOLINHA UN	0.2600	0.1300	0.1300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	20cbe2e07b1dcd2b6af609a50df7ae80	LUCELENA	12690767849	NULL	12690767849	00817	ALGODAO HIDROFILO BOLINHA UN	0.5100	0.1300	0.3800	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	20cbe2e07b1dcd2b6af609a50df7ae80	LUCELENA	12690767849	NULL	12690767849	37761	ALCOOL ETILICO 70 % ST TP ML	0.0600	0.0300	0.0300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	20cbe2e07b1dcd2b6af609a50df7ae80	LUCELENA	12690767849	NULL	12690767849	32891	EQUIPO POLIFIX 2ş VIAS UN	7.6500	0.0000	7.6500	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	20cbe2e07b1dcd2b6af609a50df7ae80	LUCELENA	12690767849	NULL	12690767849	37761	ALCOOL ETILICO 70 % ST TP ML	0.0600	0.0300	0.0300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	20cbe2e07b1dcd2b6af609a50df7ae80	LUCELENA	12690767849	NULL	12690767849	53660	EQUIPO MACRO-GOTAS FLEXIVEL C/ INJETOR LATE	6.3500	0.0000	6.3500	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	00817	ALGODAO HIDROFILO BOLINHA UN	0.5100	0.2600	0.2500	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	22748	LIDOCAINA 2% GE TP OU GR	5.1900	1.3000	3.8900	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	55255	CLEXANE (ENOXAPARINA) 60 MG SI IV SC SE	118.3000	59.1500	59.1500	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00817	ALGODAO HIDROFILO BOLINHA UN	0.2600	0.1300	0.1300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00817	ALGODAO HIDROFILO BOLINHA UN	0.2600	0.1300	0.1300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00540	AGULHA DESC 13 X 45 UN	0.7700	0.5800	0.1900	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	27596	TIRA TESTE PARA GLICOSE UN	4.1600	3.1200	1.0400	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00426	AGUA BIDESTILADA 10 ML SI IV IM AP	0.8100	0.4000	0.4100	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	13757	IODOPOVIDONA SD TP ML	0.6000	0.0000	0.6000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00817	ALGODAO HIDROFILO BOLINHA UN	0.5100	0.2600	0.2500	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	37761	ALCOOL ETILICO 70 % ST TP ML	0.0600	0.0300	0.0300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	37761	ALCOOL ETILICO 70 % ST TP ML	0.0600	0.0300	0.0300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	32891	EQUIPO POLIFIX 2ş VIAS UN	5.1000	0.0000	5.1000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	37761	ALCOOL ETILICO 70 % ST TP ML	0.0600	0.0300	0.0300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	33219	LUVA DE PROCEDIMENTO UNIDADE UN	1.0000	0.6700	0.3300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	05975	COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER	0.3000	0.0000	0.3000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	37761	ALCOOL ETILICO 70 % ST TP ML	0.0300	0.0200	0.0100	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	05975	COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER	0.3000	0.0000	0.3000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	08648	ESPARADRAPO 10 X 4.5 CM CM	0.4000	0.2000	0.2000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	37761	ALCOOL ETILICO 70 % ST TP ML	0.0300	0.0200	0.0100	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	05975	COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER	0.3000	0.0000	0.3000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	345c226bfea274af1372d41b0305a6c8	ALTINO	12720257940	NULL	12720257940	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.1000	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	345c226bfea274af1372d41b0305a6c8	ALTINO	12720257940	NULL	12720257940	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.1000	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	345c226bfea274af1372d41b0305a6c8	ALTINO	12720257940	NULL	12720257940	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.1000	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	345c226bfea274af1372d41b0305a6c8	ALTINO	12720257940	NULL	12720257940	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1750	0.0050	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	345c226bfea274af1372d41b0305a6c8	ALTINO	12720257940	NULL	12720257940	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1750	0.0050	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	31d18d6607d9e742c53e748d6a55d740	CARLOS	12557779343	NULL	12557779343	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1760	0.0040	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	31d18d6607d9e742c53e748d6a55d740	CARLOS	12557779343	NULL	12557779343	07269	DIPIRONA 500 MG/ML 2 ML SI IV IM AP	0.6900	0.6860	0.0040	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	0405a686318e3fc262f105ed4be24d95	CARMELITA	12687161644	NULL	12687161644	19160	SERINGA DESC 20 ML UN	0.5400	0.5367	0.0033	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	0405a686318e3fc262f105ed4be24d95	CARMELITA	12687161644	NULL	12687161644	19160	SERINGA DESC 20 ML UN	0.5400	0.5367	0.0033	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	752c651cb4fd049e19c685f87fbe8bdc	EDUARDO	12765990646	NULL	12765990646	00817	ALGODAO HIDROFILO BOLINHA UN	0.2600	0.0000	0.2600	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	500e4b8f04552b423f9db8f81073659f	FIDELIS	12763450340	NULL	12763450340	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1760	0.0040	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	27600	ONDANSETRONA 2 MG/ML 4 ML SI IM IV AP	13.5300	0.0000	13.5300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	19135	SERINGA DESC 03 ML UN	0.1500	0.0000	0.1500	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	19135	SERINGA DESC 03 ML UN	0.1500	0.0000	0.1500	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	08664	ESPARADRAPO MICROPORE 50 X 10 CM CM	0.2600	0.2563	0.0037	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	00426	AGUA BIDESTILADA 10 ML SI IV IM AP	0.8100	0.8075	0.0025	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	02720	BOLSA COLETORA (SISTEMA ABERTO) UN	1.2800	0.9600	0.3200	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	17310	IODOPOVIDONA ALCOOLICA SL TP ML	0.6000	0.0000	0.6000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	02720	BOLSA COLETORA (SISTEMA ABERTO) UN	1.2800	0.0000	1.2800	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	13757	IODOPOVIDONA SD TP ML	0.3000	0.2000	0.1000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	17310	IODOPOVIDONA ALCOOLICA SL TP ML	0.6000	0.0000	0.6000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	17310	IODOPOVIDONA ALCOOLICA SL TP ML	0.6000	0.0000	0.6000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	32204	CLORETO DE SODIO 0,9% 10 ML SI IV AP	0.4800	0.0000	0.4800	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	53660	EQUIPO MACRO-GOTAS FLEXIVEL C/ INJETOR LATE	3.1800	0.0000	3.1800	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	0.0000	3.4100	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	33219	LUVA DE PROCEDIMENTO UNIDADE UN	1.0000	0.6700	0.3300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	00817	ALGODAO HIDROFILO BOLINHA UN	0.2600	0.1300	0.1300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	9ffbbf7340bbd65e9e3baa9406d027f3	MARCO	12261811645	NULL	12261811645	53660	EQUIPO MACRO-GOTAS FLEXIVEL C/ INJETOR LATE	1.5900	0.0000	1.5900	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	9ffbbf7340bbd65e9e3baa9406d027f3	MARCO	12261811645	NULL	12261811645	33219	LUVA DE PROCEDIMENTO UNIDADE UN	1.0000	0.6700	0.3300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	9ffbbf7340bbd65e9e3baa9406d027f3	MARCO	12261811645	NULL	12261811645	33219	LUVA DE PROCEDIMENTO UNIDADE UN	1.0000	0.6700	0.3300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	9ffbbf7340bbd65e9e3baa9406d027f3	MARCO	12261811645	NULL	12261811645	30376	BROMETO DE IPRATROPIO 0,25MG/ML SL IN GT	2.4000	0.0000	2.4000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	9ffbbf7340bbd65e9e3baa9406d027f3	MARCO	12261811645	NULL	12261811645	02461	FENOTEROL 2 MG/ML 10 ML AE IN DS	1.0200	0.0000	1.0200	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	9ffbbf7340bbd65e9e3baa9406d027f3	MARCO	12261811645	NULL	12261811645	30376	BROMETO DE IPRATROPIO 0,25MG/ML SL IN GT	0.4000	0.0000	0.4000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	9ffbbf7340bbd65e9e3baa9406d027f3	MARCO	12261811645	NULL	12261811645	02461	FENOTEROL 2 MG/ML 10 ML AE IN DS	7.6600	0.0000	7.6600	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	5f044434edae42d3d17c4392018c7824	DINORA	12673932742	NULL	12673932742	37761	ALCOOL ETILICO 70 % ST TP ML	0.0600	0.0000	0.0600	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	d4089ccef13567fd45b16fb0b60685fa	VERA	12656425943	NULL	12656425943	33219	LUVA DE PROCEDIMENTO UNIDADE UN	1.0000	0.0000	1.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	19151	SERINGA DESC 10 ML UN	0.3300	0.0000	0.3300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.0000	0.1800	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	37761	ALCOOL ETILICO 70 % ST TP ML	0.0600	0.0300	0.0300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	00817	ALGODAO HIDROFILO BOLINHA UN	0.5100	0.2600	0.2500	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	00817	ALGODAO HIDROFILO BOLINHA UN	0.5100	0.2600	0.2500	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	37761	ALCOOL ETILICO 70 % ST TP ML	0.0600	0.0300	0.0300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	00817	ALGODAO HIDROFILO BOLINHA UN	0.5100	0.2600	0.2500	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	52582	CATETER OXIGENIO TIPO OCULOS UN	1.0000	0.0000	1.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	33219	LUVA DE PROCEDIMENTO UNIDADE UN	1.0000	0.6700	0.3300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	00817	ALGODAO HIDROFILO BOLINHA UN	0.5100	0.2600	0.2500	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.0000	0.1800	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	cd2840524be5a3f1d0939f241e24f32b	MARIA	12705908340	NULL	12705908340	33219	LUVA DE PROCEDIMENTO UNIDADE UN	1.0000	0.6700	0.3300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	cd2840524be5a3f1d0939f241e24f32b	MARIA	12705908340	NULL	12705908340	00817	ALGODAO HIDROFILO BOLINHA UN	0.2600	0.1300	0.1300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	cd2840524be5a3f1d0939f241e24f32b	MARIA	12705908340	NULL	12705908340	00817	ALGODAO HIDROFILO BOLINHA UN	0.2600	0.1300	0.1300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12603877940	NULL	12603877940	00426	AGUA BIDESTILADA 10 ML SI IV IM AP	0.4000	0.0000	0.4000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12603877940	NULL	12603877940	19151	SERINGA DESC 10 ML UN	2.0000	1.6700	0.3300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12603877940	NULL	12603877940	55018	ALGINATO DE CALCIO EM HIDROGEL GL TP GR	20.7000	13.8000	6.9000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12603877940	NULL	12603877940	11193	CLOREXIDINA 2 % ST TP ML	1.0600	0.8000	0.2600	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12603877940	NULL	12603877940	37761	ALCOOL ETILICO 70 % ST TP ML	0.0300	0.0200	0.0100	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12603877940	NULL	12603877940	37761	ALCOOL ETILICO 70 % ST TP ML	0.0300	0.0200	0.0100	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12603877940	NULL	12603877940	11193	CLOREXIDINA 2 % ST TP ML	0.8000	0.0000	0.8000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12603877940	NULL	12603877940	37761	ALCOOL ETILICO 70 % ST TP ML	0.0300	0.0200	0.0100	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12603877940	NULL	12603877940	32204	CLORETO DE SODIO 0,9% 10 ML SI IV AP	1.4400	0.9600	0.4800	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12603877940	NULL	12603877940	33219	LUVA DE PROCEDIMENTO UNIDADE UN	2.0000	0.6700	1.3300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12603877940	NULL	12603877940	27596	TIRA TESTE PARA GLICOSE UN	4.1600	3.1200	1.0400	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12603877940	NULL	12603877940	13757	IODOPOVIDONA SD TP ML	0.4000	0.0000	0.4000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00817	ALGODAO HIDROFILO BOLINHA UN	0.2600	0.1300	0.1300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	05975	COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER	0.3000	0.0000	0.3000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00817	ALGODAO HIDROFILO BOLINHA UN	0.2600	0.1300	0.1300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00817	ALGODAO HIDROFILO BOLINHA UN	0.2600	0.1300	0.1300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	818a6f2e549cc6a60aa20f9d0595eec9	ANTONIO	12565134343	NULL	12565134343	19160	SERINGA DESC 20 ML UN	0.5400	0.5371	0.0029	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	818a6f2e549cc6a60aa20f9d0595eec9	ANTONIO	12565134343	NULL	12565134343	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1765	0.0035	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	818a6f2e549cc6a60aa20f9d0595eec9	ANTONIO	12565134343	NULL	12565134343	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1767	0.0033	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	a050ed50115d2a6dd0b15b99b39063da	ARI	12676101147	NULL	12676101147	11304	HIDROCORTISONA 500 MG PO IM IV FA	6.3500	6.3400	0.0000	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	a050ed50115d2a6dd0b15b99b39063da	ARI	12676101147	NULL	12676101147	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1750	0.0050	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	a050ed50115d2a6dd0b15b99b39063da	ARI	12676101147	NULL	12676101147	19160	SERINGA DESC 20 ML UN	0.5400	0.5367	0.0033	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	a050ed50115d2a6dd0b15b99b39063da	ARI	12676101147	NULL	12676101147	19160	SERINGA DESC 20 ML UN	0.5400	0.5367	0.0033	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	a050ed50115d2a6dd0b15b99b39063da	ARI	12676101147	NULL	12676101147	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4067	0.0033	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	a050ed50115d2a6dd0b15b99b39063da	ARI	12676101147	NULL	12676101147	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4067	0.0033	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	a050ed50115d2a6dd0b15b99b39063da	ARI	12676101147	NULL	12676101147	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4067	0.0033	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	edffb7fef608512400078fdf75991573	CARLA	12728631049	NULL	12728631049	32190	CLORETO DE POTASSIO 10% 10 ML SI IV AP	0.3000	0.2900	0.0000	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	edffb7fef608512400078fdf75991573	CARLA	12728631049	NULL	12728631049	19160	SERINGA DESC 20 ML UN	0.5400	0.5300	0.0000	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	edffb7fef608512400078fdf75991573	CARLA	12728631049	NULL	12728631049	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1760	0.0040	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	39df67956a358bf1eab89803158d25dd	HELENA	12655863342	NULL	12655863342	20672	SORO RINGER SIMPLES 500 ML SI IV BS	5.9400	5.9300	0.0000	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	39df67956a358bf1eab89803158d25dd	HELENA	12655863342	NULL	12655863342	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1750	0.0050	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	39df67956a358bf1eab89803158d25dd	HELENA	12655863342	NULL	12655863342	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1750	0.0050	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	39df67956a358bf1eab89803158d25dd	HELENA	12655863342	NULL	12655863342	33219	LUVA DE PROCEDIMENTO UNIDADE UN	1.6700	1.6647	0.0053	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	4668d2494ed6c4b2d18be299efcb26a2	JOAO	12469689344	NULL	12469689344	08664	ESPARADRAPO MICROPORE 50 X 10 CM CM	1.0200	0.2600	0.7600	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	00817	ALGODAO HIDROFILO BOLINHA UN	0.7600	0.2600	0.5000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	01081195	5b1e846d62341272eec7cc65f2fed2e7	ANGELIA	12734665810	NULL	12734665810	00010014	CONSULTA EM CONSULTORIO MEDICO	0.0000	35.0000	NULL	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	01081195	3571a431fcd5a8ae3aaed00994dd4300	DARIO	12737609412	NULL	12737609412	00010014	CONSULTA EM CONSULTORIO MEDICO	0.0000	35.0000	NULL	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	01081197	3af14fcc4f764a77ed38b3d2e81bcc76	JOAO	12687535922	NULL	12687535922	34010130	TOMOGRAFIA COMPUTADORIZADA DO TORAX	0.0000	280.6875	NULL	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	2a79bf9d53875b480086bd7b8321c4f1	JOSE	12641066643	NULL	12641066643	25040014	ASSISTENCIA FISIATRICA RESPIRATORIA	0.0000	15.0800	NULL	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	20cbe2e07b1dcd2b6af609a50df7ae80	LUCELENA	12690767849	NULL	12690767849	25040014	ASSISTENCIA FISIATRICA RESPIRATORIA	0.0000	55.3100	NULL	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	6799aa3de305405ab065aad5b599765c	VANIR	12700232345	NULL	12700232345	25040014	ASSISTENCIA FISIATRICA RESPIRATORIA	0.0000	10.0600	NULL	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	eecb3d883747b059c3fe231c34567476	AFFRIDES	12693180144	NULL	12693180144	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1770	0.0030	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	eecb3d883747b059c3fe231c34567476	AFFRIDES	12693180144	NULL	12693180144	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1770	0.0030	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	eecb3d883747b059c3fe231c34567476	AFFRIDES	12693180144	NULL	12693180144	00426	AGUA BIDESTILADA 10 ML SI IV IM AP	0.8100	0.8072	0.0028	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	eecb3d883747b059c3fe231c34567476	AFFRIDES	12693180144	NULL	12693180144	00426	AGUA BIDESTILADA 10 ML SI IV IM AP	0.8100	0.8072	0.0028	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	eecb3d883747b059c3fe231c34567476	AFFRIDES	12693180144	NULL	12693180144	00426	AGUA BIDESTILADA 10 ML SI IV IM AP	0.8100	0.8072	0.0028	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	eecb3d883747b059c3fe231c34567476	AFFRIDES	12693180144	NULL	12693180144	09733	ACETILCISTEINA 600MG PO VO SA	3.5000	3.4940	0.0060	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	eecb3d883747b059c3fe231c34567476	AFFRIDES	12693180144	NULL	12693180144	09733	ACETILCISTEINA 600MG PO VO SA	3.5000	3.4955	0.0045	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	eecb3d883747b059c3fe231c34567476	AFFRIDES	12693180144	NULL	12693180144	09733	ACETILCISTEINA 600MG PO VO SA	3.5000	3.4955	0.0045	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	08664	ESPARADRAPO MICROPORE 50 X 10 CM CM	0.2600	0.2561	0.0039	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	08664	ESPARADRAPO MICROPORE 50 X 10 CM CM	0.7700	0.7682	0.0018	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	08664	ESPARADRAPO MICROPORE 50 X 10 CM CM	0.7700	0.7682	0.0018	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	37761	ALCOOL ETILICO 70 % ST TP ML	0.0200	0.0150	0.0050	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	20672	SORO RINGER SIMPLES 500 ML SI IV BS	5.9400	5.9367	0.0033	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	22896	CEFUROXIMA 750 MG + DIL. 6 ML PO IM IV FA	26.1300	26.1274	0.0026	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	22896	CEFUROXIMA 750 MG + DIL. 6 ML PO IM IV FA	26.1300	26.1271	0.0029	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	42358	FUROSEMIDA 10 MG/ML 2 ML SI IM IV AP	0.6000	0.5986	0.0014	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4078	0.0022	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4078	0.0022	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4078	0.0022	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4078	0.0022	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4078	0.0022	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4078	0.0022	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	33227	LUVA CIRURGICA PAR UN	1.4500	1.4476	0.0024	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	33227	LUVA CIRURGICA PAR UN	1.4500	1.4476	0.0024	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	33227	LUVA CIRURGICA PAR UN	1.4500	1.4476	0.0024	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	33227	LUVA CIRURGICA PAR UN	1.4500	1.4476	0.0024	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	33227	LUVA CIRURGICA PAR UN	1.4500	1.4476	0.0024	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	33227	LUVA CIRURGICA PAR UN	1.4500	1.4476	0.0024	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.1038	-0.0038	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.1038	-0.0038	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	b288bbcfb9aecab51bcb0dba62ca0059	IVONETE	12743730847	NULL	12743730847	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4067	0.0033	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	b288bbcfb9aecab51bcb0dba62ca0059	IVONETE	12743730847	NULL	12743730847	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4067	0.0033	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	b288bbcfb9aecab51bcb0dba62ca0059	IVONETE	12743730847	NULL	12743730847	19160	SERINGA DESC 20 ML UN	0.5400	0.5367	0.0033	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	b288bbcfb9aecab51bcb0dba62ca0059	IVONETE	12743730847	NULL	12743730847	19160	SERINGA DESC 20 ML UN	0.5400	0.5367	0.0033	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12558131243	NULL	12558131243	33219	LUVA DE PROCEDIMENTO UNIDADE UN	0.6700	0.6680	0.0020	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	11193	CLOREXIDINA 2 % ST TP ML	0.5300	0.0000	0.5300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	05975	COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER	0.3000	0.0000	0.3000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	32891	EQUIPO POLIFIX 2ş VIAS UN	2.5500	0.0000	2.5500	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4084	0.0016	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4084	0.0016	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4084	0.0016	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4084	0.0016	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4084	0.0016	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4084	0.0016	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4084	0.0016	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4084	0.0016	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4084	0.0016	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4084	0.0016	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4084	0.0016	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	2a79bf9d53875b480086bd7b8321c4f1	JOSE	12641066643	NULL	12641066643	12262	ISOSSORBIDA 20 MG CP VO UN	0.2200	0.2165	0.0035	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	2a79bf9d53875b480086bd7b8321c4f1	JOSE	12641066643	NULL	12641066643	12262	ISOSSORBIDA 20 MG CP VO UN	0.2200	0.2167	0.0033	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	2a79bf9d53875b480086bd7b8321c4f1	JOSE	12641066643	NULL	12641066643	12262	ISOSSORBIDA 20 MG CP VO UN	0.2200	0.2167	0.0033	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1965b0cdebe9017c3397c8641147759	JOSE	12705413746	NULL	12705413746	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4074	0.0026	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	670141098c0309ac9be3db204bdc12cf	LEOSINA	12706525442	NULL	12706525442	08664	ESPARADRAPO MICROPORE 50 X 10 CM CM	0.7700	0.7600	0.0000	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	20cbe2e07b1dcd2b6af609a50df7ae80	LUCELENA	12690767849	NULL	12690767849	19160	SERINGA DESC 20 ML UN	0.5400	0.5384	0.0016	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	02461	FENOTEROL 2 MG/ML 10 ML AE IN DS	0.3400	0.0000	0.3400	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	32204	CLORETO DE SODIO 0,9% 10 ML SI IV AP	0.4800	0.4800	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	32204	CLORETO DE SODIO 0,9% 10 ML SI IV AP	0.4800	0.0000	0.4800	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	00426	AGUA BIDESTILADA 10 ML SI IV IM AP	0.8100	0.8067	0.0033	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	00426	AGUA BIDESTILADA 10 ML SI IV IM AP	0.8100	0.8067	0.0033	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	00426	AGUA BIDESTILADA 10 ML SI IV IM AP	0.8100	0.8067	0.0033	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	00426	AGUA BIDESTILADA 10 ML SI IV IM AP	0.8100	0.8067	0.0033	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	00426	AGUA BIDESTILADA 10 ML SI IV IM AP	0.8100	0.8067	0.0033	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	00426	AGUA BIDESTILADA 10 ML SI IV IM AP	0.8100	0.8067	0.0033	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	00426	AGUA BIDESTILADA 10 ML SI IV IM AP	0.8100	0.8067	0.0033	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	00426	AGUA BIDESTILADA 10 ML SI IV IM AP	0.8100	0.8067	0.0033	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	00426	AGUA BIDESTILADA 10 ML SI IV IM AP	0.8100	0.8067	0.0033	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	32204	CLORETO DE SODIO 0,9% 10 ML SI IV AP	0.4800	0.0000	0.4800	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	32204	CLORETO DE SODIO 0,9% 10 ML SI IV AP	0.4800	0.4800	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	32204	CLORETO DE SODIO 0,9% 10 ML SI IV AP	0.4800	0.4800	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	32204	CLORETO DE SODIO 0,9% 10 ML SI IV AP	0.9600	0.9600	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	32204	CLORETO DE SODIO 0,9% 10 ML SI IV AP	0.9600	0.9600	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	32204	CLORETO DE SODIO 0,9% 10 ML SI IV AP	0.4800	0.0000	0.4800	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	32204	CLORETO DE SODIO 0,9% 10 ML SI IV AP	0.9600	0.0000	0.9600	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	32891	EQUIPO POLIFIX 2ş VIAS UN	2.5500	0.0000	2.5500	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	32891	EQUIPO POLIFIX 2ş VIAS UN	2.5500	0.0000	2.5500	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	32204	CLORETO DE SODIO 0,9% 10 ML SI IV AP	0.4800	0.0000	0.4800	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	32204	CLORETO DE SODIO 0,9% 10 ML SI IV AP	0.4800	0.0000	0.4800	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	32204	CLORETO DE SODIO 0,9% 10 ML SI IV AP	0.4800	0.0000	0.4800	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	32204	CLORETO DE SODIO 0,9% 10 ML SI IV AP	0.4800	0.0000	0.4800	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	e715e2ae28a6229c8609756d3298bf52	MARIA	12734221144	NULL	12734221144	00035	ABOCATH (CATETER INTRAVENOSO) N. 14 A 22 UN	3.7700	3.7600	0.0000	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	e715e2ae28a6229c8609756d3298bf52	MARIA	12734221144	NULL	12734221144	30511	CEFALOTINA 1 G FA + DIL. 10 ML FA	4.6600	4.6550	0.0050	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	e715e2ae28a6229c8609756d3298bf52	MARIA	12734221144	NULL	12734221144	30511	CEFALOTINA 1 G FA + DIL. 10 ML FA	4.6600	4.6550	0.0050	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	11193	CLOREXIDINA 2 % ST TP ML	0.2700	0.2650	0.0050	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	11193	CLOREXIDINA 2 % ST TP ML	0.5300	0.0000	0.5300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	33537	PIPERACILINA 2 G + TAZOBACTAM 250 MG 30 ML	55.3400	55.3375	0.0025	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	33537	PIPERACILINA 2 G + TAZOBACTAM 250 MG 30 ML	55.3400	55.3375	0.0025	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	33537	PIPERACILINA 2 G + TAZOBACTAM 250 MG 30 ML	55.3400	55.3375	0.0025	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4061	0.0039	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4061	0.0039	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4061	0.0039	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4061	0.0039	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	33227	LUVA CIRURGICA PAR UN	1.4500	2.8955	-1.4455	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	33227	LUVA CIRURGICA PAR UN	1.4500	2.8955	-1.4455	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	33227	LUVA CIRURGICA PAR UN	1.4500	1.4477	0.0023	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	33227	LUVA CIRURGICA PAR UN	1.4500	1.4477	0.0023	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	33227	LUVA CIRURGICA PAR UN	1.4500	1.4477	0.0023	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	33227	LUVA CIRURGICA PAR UN	1.4500	1.4477	0.0023	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	33227	LUVA CIRURGICA PAR UN	1.4500	1.4477	0.0023	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	33227	LUVA CIRURGICA PAR UN	1.4500	1.4477	0.0023	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	33227	LUVA CIRURGICA PAR UN	1.4500	1.4477	0.0023	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	19135	SERINGA DESC 03 ML UN	0.1500	0.0000	0.1500	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	19135	SERINGA DESC 03 ML UN	0.1500	0.0000	0.1500	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	19135	SERINGA DESC 03 ML UN	0.1500	0.0000	0.1500	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	19135	SERINGA DESC 03 ML UN	0.1500	0.0000	0.1500	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	08664	ESPARADRAPO MICROPORE 50 X 10 CM CM	0.7700	0.2550	0.5150	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.2100	0.2057	0.0043	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.2100	0.2057	0.0043	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.2100	0.2057	0.0043	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1772	0.0028	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1772	0.0028	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1772	0.0028	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1772	0.0028	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1772	0.0028	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1772	0.0028	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1772	0.0028	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	cd2840524be5a3f1d0939f241e24f32b	MARIA	12705908340	NULL	12705908340	32204	CLORETO DE SODIO 0,9% 10 ML SI IV AP	0.4800	0.4800	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	cd2840524be5a3f1d0939f241e24f32b	MARIA	12705908340	NULL	12705908340	33219	LUVA DE PROCEDIMENTO UNIDADE UN	0.3300	0.0000	0.3300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	cd2840524be5a3f1d0939f241e24f32b	MARIA	12705908340	NULL	12705908340	30376	BROMETO DE IPRATROPIO 0,25MG/ML SL IN GT	0.4000	0.0000	0.4000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	cd2840524be5a3f1d0939f241e24f32b	MARIA	12705908340	NULL	12705908340	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1768	0.0032	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	cd2840524be5a3f1d0939f241e24f32b	MARIA	12705908340	NULL	12705908340	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1764	0.0036	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	cd2840524be5a3f1d0939f241e24f32b	MARIA	12705908340	NULL	12705908340	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1764	0.0036	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	cd2840524be5a3f1d0939f241e24f32b	MARIA	12705908340	NULL	12705908340	02461	FENOTEROL 2 MG/ML 10 ML AE IN DS	0.4300	0.0000	0.4300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	d17b3c5ae418d82694895a326dee545a	ODILIA	12670516743	NULL	12670516743	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1768	0.0032	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	d17b3c5ae418d82694895a326dee545a	ODILIA	12670516743	NULL	12670516743	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1774	0.0026	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1766	0.0034	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	8a5ecfde671848d05ac757e0112e689c	TEREZINHA	12700337042	NULL	12700337042	57258	FUMARATO DE QUETIAPINA 25 MG CA VO UN	1.2500	1.2450	0.0050	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	8a5ecfde671848d05ac757e0112e689c	TEREZINHA	12700337042	NULL	12700337042	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4071	0.0029	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	8a5ecfde671848d05ac757e0112e689c	TEREZINHA	12700337042	NULL	12700337042	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4071	0.0029	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	8a5ecfde671848d05ac757e0112e689c	TEREZINHA	12700337042	NULL	12700337042	19160	SERINGA DESC 20 ML UN	0.5400	0.5376	0.0024	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	8a5ecfde671848d05ac757e0112e689c	TEREZINHA	12700337042	NULL	12700337042	19160	SERINGA DESC 20 ML UN	0.5400	0.5376	0.0024	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	8a5ecfde671848d05ac757e0112e689c	TEREZINHA	12700337042	NULL	12700337042	19160	SERINGA DESC 20 ML UN	0.5400	0.5376	0.0024	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	8a5ecfde671848d05ac757e0112e689c	TEREZINHA	12700337042	NULL	12700337042	19160	SERINGA DESC 20 ML UN	0.5400	0.5376	0.0024	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	70cf23c63f890f0b61da2542c3e13a09	TIAGO	12741864645	NULL	12741864645	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1762	0.0038	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	70cf23c63f890f0b61da2542c3e13a09	TIAGO	12741864645	NULL	12741864645	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1762	0.0038	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	70cf23c63f890f0b61da2542c3e13a09	TIAGO	12741864645	NULL	12741864645	19160	SERINGA DESC 20 ML UN	0.5400	0.5367	0.0033	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	32204	CLORETO DE SODIO 0,9% 10 ML SI IV AP	0.4800	0.0000	0.4800	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	05975	COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER	0.3000	0.1857	0.1143	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4070	0.0030	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	0111beed375944f60c7ad4a7fd4874f8	WALDIR	12746025744	NULL	12746025744	00426	AGUA BIDESTILADA 10 ML SI IV IM AP	0.8100	0.8074	0.0026	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	0111beed375944f60c7ad4a7fd4874f8	WALDIR	12746025744	NULL	12746025744	00426	AGUA BIDESTILADA 10 ML SI IV IM AP	1.6200	1.6147	0.0053	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	0111beed375944f60c7ad4a7fd4874f8	WALDIR	12746025744	NULL	12746025744	00426	AGUA BIDESTILADA 10 ML SI IV IM AP	1.6200	1.6147	0.0053	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	0111beed375944f60c7ad4a7fd4874f8	WALDIR	12746025744	NULL	12746025744	00426	AGUA BIDESTILADA 10 ML SI IV IM AP	1.6200	1.6147	0.0053	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	0111beed375944f60c7ad4a7fd4874f8	WALDIR	12746025744	NULL	12746025744	00426	AGUA BIDESTILADA 10 ML SI IV IM AP	1.6200	1.6147	0.0053	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	0111beed375944f60c7ad4a7fd4874f8	WALDIR	12746025744	NULL	12746025744	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4076	0.0024	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	0111beed375944f60c7ad4a7fd4874f8	WALDIR	12746025744	NULL	12746025744	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4076	0.0024	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	0111beed375944f60c7ad4a7fd4874f8	WALDIR	12746025744	NULL	12746025744	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4076	0.0024	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	0111beed375944f60c7ad4a7fd4874f8	WALDIR	12746025744	NULL	12746025744	19160	SERINGA DESC 20 ML UN	0.5400	0.5379	0.0021	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	0111beed375944f60c7ad4a7fd4874f8	WALDIR	12746025744	NULL	12746025744	19160	SERINGA DESC 20 ML UN	0.5400	0.5379	0.0021	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	37761	ALCOOL ETILICO 70 % ST TP ML	0.0300	0.0000	0.0300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	00817	ALGODAO HIDROFILO BOLINHA UN	0.5100	0.2600	0.2500	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	00817	ALGODAO HIDROFILO BOLINHA UN	0.5100	0.0000	0.5100	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	27596	TIRA TESTE PARA GLICOSE UN	1.0400	1.0400	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	27596	TIRA TESTE PARA GLICOSE UN	1.0400	1.0400	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	27596	TIRA TESTE PARA GLICOSE UN	1.0400	1.0400	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	27596	TIRA TESTE PARA GLICOSE UN	1.0400	1.0400	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	27596	TIRA TESTE PARA GLICOSE UN	1.0400	1.0400	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12647284040	NULL	12647284040	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4086	0.0014	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12647284040	NULL	12647284040	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4086	0.0014	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12647284040	NULL	12647284040	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4086	0.0014	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12662414945	NULL	12662414945	19445	CLORETO DE POTASSIO 600 MG CA VO UN	0.4900	0.4867	0.0033	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12662414945	NULL	12662414945	42358	FUROSEMIDA 10 MG/ML 2 ML SI IM IV AP	0.6000	0.5982	0.0018	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12662414945	NULL	12662414945	42358	FUROSEMIDA 10 MG/ML 2 ML SI IM IV AP	0.6000	0.5983	0.0017	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12662414945	NULL	12662414945	42358	FUROSEMIDA 10 MG/ML 2 ML SI IM IV AP	1.2000	1.1967	0.0033	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12662414945	NULL	12662414945	42358	FUROSEMIDA 10 MG/ML 2 ML SI IM IV AP	1.2000	1.1967	0.0033	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12662414945	NULL	12662414945	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4064	0.0036	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12662414945	NULL	12662414945	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4071	0.0029	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12662414945	NULL	12662414945	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4071	0.0029	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12579183644	NULL	12579183644	05975	COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER	0.3000	0.0000	0.3000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12579183644	NULL	12579183644	05975	COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER	0.3000	0.3000	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12579183644	NULL	12579183644	05975	COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER	0.3000	0.0000	0.3000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12579183644	NULL	12579183644	33227	LUVA CIRURGICA PAR UN	1.4500	1.4476	0.0024	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12579183644	NULL	12579183644	33227	LUVA CIRURGICA PAR UN	1.4500	1.4476	0.0024	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12579183644	NULL	12579183644	33227	LUVA CIRURGICA PAR UN	1.4500	1.4476	0.0024	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12579183644	NULL	12579183644	33227	LUVA CIRURGICA PAR UN	1.4500	1.4476	0.0024	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1770	0.0030	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1770	0.0030	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	00124	LUVA CIRURGICA UN	NULL	0.0000	NULL	OPME INVALIDO	2201
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	27042	CLOREXIDINA 2 % ST TP ML DEGERMANTE	NULL	0.0000	NULL	OPME INVALIDO	2201
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	00481	PROTAMINA 1000 UI/ML 5 ML SI IV AP	NULL	0.0000	NULL	OPME INVALIDO	2201
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	37761	ALCOOL ETILICO 70 % ST TP ML	0.0300	0.0200	0.0100	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00817	ALGODAO HIDROFILO BOLINHA UN	0.2600	0.0000	0.2600	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	32204	CLORETO DE SODIO 0,9% 10 ML SI IV AP	0.4800	0.0000	0.4800	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00817	ALGODAO HIDROFILO BOLINHA UN	0.2600	0.1300	0.1300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.2120	-0.1120	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.2120	-0.1120	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.2120	-0.1120	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.2120	-0.1120	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.2120	-0.1120	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.2120	-0.1120	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.2120	-0.1120	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.2120	-0.1120	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.2120	-0.1120	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.2120	-0.1120	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.1060	-0.0060	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.1060	-0.0060	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.1060	-0.0060	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.1060	-0.0060	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.1060	-0.0060	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.1060	-0.0060	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.1060	-0.0060	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.1060	-0.0060	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.1060	-0.0060	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.1060	-0.0060	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	34827	TIORFAN (RACECADOTRILA) 100 MG CA VO UN	3.2000	6.4000	-3.2000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	34827	TIORFAN (RACECADOTRILA) 100 MG CA VO UN	3.2000	6.4000	-3.2000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	34827	TIORFAN (RACECADOTRILA) 100 MG CA VO UN	3.2000	6.4000	-3.2000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	27596	TIRA TESTE PARA GLICOSE UN	1.0400	1.0400	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	27596	TIRA TESTE PARA GLICOSE UN	1.0400	1.0400	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	19160	SERINGA DESC 20 ML UN	0.5400	0.5374	0.0026	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	19160	SERINGA DESC 20 ML UN	0.5400	0.5374	0.0026	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	19445	CLORETO DE POTASSIO 600 MG CA VO UN	1.4637	1.9474	-1.4574	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	19445	CLORETO DE POTASSIO 600 MG CA VO UN	0.9768	1.4605	-0.9705	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	31585	RANITIDINA 25 MG/ML 2 ML SI IV IM AP	0.9300	1.8668	-0.9368	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	31585	RANITIDINA 25 MG/ML 2 ML SI IV IM AP	0.9300	0.9334	-0.0034	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	31585	RANITIDINA 25 MG/ML 2 ML SI IV IM AP	0.9300	0.9334	-0.0034	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	19151	SERINGA DESC 10 ML UN	0.6634	1.0003	-0.6703	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	19151	SERINGA DESC 10 ML UN	0.6634	1.0003	-0.6703	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	19151	SERINGA DESC 10 ML UN	0.3300	0.6669	-0.3369	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	19151	SERINGA DESC 10 ML UN	0.3300	0.6669	-0.3369	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	19151	SERINGA DESC 10 ML UN	0.3300	0.6669	-0.3369	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	19151	SERINGA DESC 10 ML UN	0.3300	0.6669	-0.3369	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	19151	SERINGA DESC 10 ML UN	0.3300	0.6669	-0.3369	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	19151	SERINGA DESC 10 ML UN	0.3300	0.6669	-0.3369	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	19151	SERINGA DESC 10 ML UN	0.3300	0.6669	-0.3369	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00817	ALGODAO HIDROFILO BOLINHA UN	0.2860	0.3120	-0.0520	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00817	ALGODAO HIDROFILO BOLINHA UN	0.2860	0.3120	-0.0520	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	37761	ALCOOL ETILICO 70 % ST TP ML	0.0631	0.0695	-0.0395	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	53660	EQUIPO MACRO-GOTAS FLEXIVEL C/ INJETOR LATE	1.5900	3.1800	-1.5900	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	53660	EQUIPO MACRO-GOTAS FLEXIVEL C/ INJETOR LATE	1.5900	1.5900	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	53660	EQUIPO MACRO-GOTAS FLEXIVEL C/ INJETOR LATE	1.5900	1.5900	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	21822	TRAMADOL 50 MG 1 ML SI IM IV AP	25.1571	29.3540	-25.1640	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	11193	CLOREXIDINA 2 % ST TP ML	0.5300	0.5320	-0.0020	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	11193	CLOREXIDINA 2 % ST TP ML	0.5300	0.5320	-0.0020	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	800720d33fe0defb6121e82dd216d044	JALMO	12786952647	NULL	12786952647	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	0.0000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4075	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00171	SORO FISIOLOGICO 0,9% 250 ML SI IV BS	0.0000	3.9400	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	02246	HIDROCORTISONA 100 MG PO IM IV FA	0.0000	0.0000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	02246	HIDROCORTISONA 100 MG PO IM IV FA	0.0000	5.6689	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	26981	SORO FISIOLOGICO 0,9% 10 ML SI IV AP	0.0000	0.9600	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00613	CLINDAMICINA 600 MG 4 ML SI IM IV AP	0.0000	13.0800	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00613	CLINDAMICINA 600 MG 4 ML SI IM IV AP	0.0000	13.0800	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00069	SERINGA DESC 10 ML UN	0.0000	0.0000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00069	SERINGA DESC 10 ML UN	0.0000	0.0000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00735	CEFTRIAXONA IV 1G + DIL. 10 ML PO IV FA	0.0000	27.0600	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00735	CEFTRIAXONA IV 1G + DIL. 10 ML PO IV FA	0.0000	54.1300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00735	CEFTRIAXONA IV 1G + DIL. 10 ML PO IV FA	0.0000	54.1300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	07802	PIPERACILINA 4 G + TAZOBACTAM 500 MG PO IV FA	0.0000	83.4500	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	07802	PIPERACILINA 4 G + TAZOBACTAM 500 MG PO IV FA	0.0000	83.4500	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	07802	PIPERACILINA 4 G + TAZOBACTAM 500 MG PO IV FA	0.0000	83.4500	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	07802	PIPERACILINA 4 G + TAZOBACTAM 500 MG PO IV FA	0.0000	83.4500	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	08829	Bricanyl 0,5mg Inj. Ampola C/ 1ml	0.0000	3.5900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	08829	Bricanyl 0,5mg Inj. Ampola C/ 1ml	0.0000	3.5900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	09071	ACETILCISTEINA 600MG PO VO SA	0.0000	3.4950	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	09071	ACETILCISTEINA 600MG PO VO SA	0.0000	3.4950	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00090	SERINGA DESC 20 ML UN	0.0000	0.0000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00124	LUVA CIRURGICA UN	0.0000	1.4475	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00124	LUVA CIRURGICA UN	0.0000	1.4475	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00124	LUVA CIRURGICA UN	0.0000	1.4475	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4062	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4062	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4062	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4062	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4062	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4062	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4062	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	01584	NEOSTIGMINA 0,5 MG/ML 1 ML SI IM IV SC AP	0.0000	0.7667	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00170	SORO GLICOSADO 5% 250 ML SI IV BS	0.0000	3.4000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	24082	BROMOPRIDA 5 MG/ML 2 ML SI IM IV AP	0.0000	2.7300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	24082	BROMOPRIDA 5 MG/ML 2 ML SI IM IV AP	0.0000	2.7300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	24082	BROMOPRIDA 5 MG/ML 2 ML SI IM IV AP	0.0000	2.7300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	24082	BROMOPRIDA 5 MG/ML 2 ML SI IM IV AP	0.0000	2.7300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	24082	BROMOPRIDA 5 MG/ML 2 ML SI IM IV AP	0.0000	2.7300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	24082	BROMOPRIDA 5 MG/ML 2 ML SI IM IV AP	0.0000	2.7300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	24082	BROMOPRIDA 5 MG/ML 2 ML SI IM IV AP	0.0000	2.7300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00090	SERINGA DESC 20 ML UN	0.0000	0.5371	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00090	SERINGA DESC 20 ML UN	0.0000	0.5371	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00090	SERINGA DESC 20 ML UN	0.0000	0.5371	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00090	SERINGA DESC 20 ML UN	0.0000	0.5371	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00090	SERINGA DESC 20 ML UN	0.0000	0.5371	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00090	SERINGA DESC 20 ML UN	0.0000	0.5371	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00090	SERINGA DESC 20 ML UN	0.0000	0.5371	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00090	SERINGA DESC 20 ML UN	0.0000	0.5371	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00090	SERINGA DESC 20 ML UN	0.0000	0.5371	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00090	SERINGA DESC 20 ML UN	0.0000	0.5371	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00090	SERINGA DESC 20 ML UN	0.0000	0.5371	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00090	SERINGA DESC 20 ML UN	0.0000	0.5371	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00090	SERINGA DESC 20 ML UN	0.0000	0.5371	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00090	SERINGA DESC 20 ML UN	0.0000	0.5371	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00090	SERINGA DESC 20 ML UN	0.0000	0.5371	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00090	SERINGA DESC 20 ML UN	0.0000	0.5371	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00090	SERINGA DESC 20 ML UN	0.0000	0.5371	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00943	EQUIPO POLIFIX 2 VIAS UN	0.0000	2.5500	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4088	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1766	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1766	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1766	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00090	SERINGA DESC 20 ML UN	0.0000	0.5387	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00090	SERINGA DESC 20 ML UN	0.0000	0.5387	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00090	SERINGA DESC 20 ML UN	0.0000	0.0000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00090	SERINGA DESC 20 ML UN	0.0000	0.5387	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00090	SERINGA DESC 20 ML UN	0.0000	0.5387	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00090	SERINGA DESC 20 ML UN	0.0000	0.5387	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00090	SERINGA DESC 20 ML UN	0.0000	0.5387	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00090	SERINGA DESC 20 ML UN	0.0000	0.5387	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00090	SERINGA DESC 20 ML UN	0.0000	0.5387	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00090	SERINGA DESC 20 ML UN	0.0000	0.5387	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00090	SERINGA DESC 20 ML UN	0.0000	0.5400	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00090	SERINGA DESC 20 ML UN	0.0000	0.5387	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00090	SERINGA DESC 20 ML UN	0.0000	0.5387	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00090	SERINGA DESC 20 ML UN	0.0000	0.5387	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00090	SERINGA DESC 20 ML UN	0.0000	0.5387	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00090	SERINGA DESC 20 ML UN	0.0000	0.5387	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00090	SERINGA DESC 20 ML UN	0.0000	0.5387	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00090	SERINGA DESC 20 ML UN	0.0000	0.5387	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00090	SERINGA DESC 20 ML UN	0.0000	0.5387	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00090	SERINGA DESC 20 ML UN	0.0000	0.5400	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00090	SERINGA DESC 20 ML UN	0.0000	0.5400	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12550571048	NULL	12550571048	00124	LUVA CIRURGICA UN	0.0000	1.4500	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12550571048	NULL	12550571048	00124	LUVA CIRURGICA UN	0.0000	1.4473	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12550571048	NULL	12550571048	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4074	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12550571048	NULL	12550571048	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12550571048	NULL	12550571048	01611	CLORETO DE POTASSIO 600 MG CA VO UN	0.0000	0.4867	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12550571048	NULL	12550571048	01611	CLORETO DE POTASSIO 600 MG CA VO UN	0.0000	0.4867	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12550571048	NULL	12550571048	01611	CLORETO DE POTASSIO 600 MG CA VO UN	0.0000	0.4867	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12550571048	NULL	12550571048	01611	CLORETO DE POTASSIO 600 MG CA VO UN	0.0000	0.4867	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12550571048	NULL	12550571048	01611	CLORETO DE POTASSIO 600 MG CA VO UN	0.0000	0.9733	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12550571048	NULL	12550571048	25040014	Fisioterapia Respiratória - em Doente Clínico Internado	0.0000	5.0300	NULL	EXAME NAO AUTORIZADO	2707
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12550571048	NULL	12550571048	29020166	Nebulização Simples com Broncodilatador	0.0000	7.0200	NULL	EXAME NAO AUTORIZADO	2707
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12550571048	NULL	12550571048	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.0000	0.8073	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12550571048	NULL	12550571048	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1775	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12550571048	NULL	12550571048	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1775	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12550571048	NULL	12550571048	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1800	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12550571048	NULL	12550571048	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1775	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12550571048	NULL	12550571048	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1775	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12550571048	NULL	12550571048	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1775	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12550571048	NULL	12550571048	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1775	NULL	VALOR APRESENTADO A MAIOR	1705
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12550571048	NULL	12550571048	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1775	NULL	VALOR APRESENTADO A MAIOR	1705
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12579183644	NULL	12579183644	25040014	Fisioterapia Respiratória - em Doente Clínico Internado	0.0000	10.0600	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12579183644	NULL	12579183644	25040014	Fisioterapia Respiratória - em Doente Clínico Internado	0.0000	10.0600	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12579183644	NULL	12579183644	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12579183644	NULL	12579183644	35382	COMPRESSAS DE GASES 7.5 X7,5 (11 FIOS ESTERIL) UN	0.0000	0.3000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12579183644	NULL	12579183644	35382	COMPRESSAS DE GASES 7.5 X7,5 (11 FIOS ESTERIL) UN	0.0000	0.0000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12579183644	NULL	12579183644	35382	COMPRESSAS DE GASES 7.5 X7,5 (11 FIOS ESTERIL) UN	0.0000	0.3000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12579183644	NULL	12579183644	35382	COMPRESSAS DE GASES 7.5 X7,5 (11 FIOS ESTERIL) UN	0.0000	0.6000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12579183644	NULL	12579183644	00090	SERINGA DESC 20 ML UN	0.0000	0.5367	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	00124	LUVA CIRURGICA UN	0.0000	1.4482	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	00124	LUVA CIRURGICA UN	0.0000	1.4500	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	00124	LUVA CIRURGICA UN	0.0000	1.4482	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	00124	LUVA CIRURGICA UN	0.0000	1.4500	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	00124	LUVA CIRURGICA UN	0.0000	1.4500	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	35382	COMPRESSAS DE GASES 7.5 X7,5 (11 FIOS ESTERIL) UN	0.0000	0.0600	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.0000	0.4000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.0000	0.4000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.0000	0.4000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.0000	0.4000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.0000	0.4000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1752	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1752	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1748	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1752	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	51241	AGULHA 123X45	0.0000	0.1900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	51590	ABAIXADOR DE LINGUA UN	0.0000	0.0500	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	51590	ABAIXADOR DE LINGUA UN	0.0000	0.0500	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	51649	ALCOOL ETILICO 70 % ST TP ML	0.0000	0.0300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	51649	ALCOOL ETILICO 70 % ST TP ML	0.0000	0.0300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	52392	SONDA DE ASPIRAÇAO TRAQUEAL C/ VALVULA UN	0.0000	0.9352	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	52392	SONDA DE ASPIRAÇAO TRAQUEAL C/ VALVULA UN	0.0000	0.9400	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	52392	SONDA DE ASPIRAÇAO TRAQUEAL C/ VALVULA UN	0.0000	0.9352	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	52392	SONDA DE ASPIRAÇAO TRAQUEAL C/ VALVULA UN	0.0000	0.9352	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.0000	0.6874	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.0000	0.6874	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.0000	0.6874	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.0000	0.6874	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.0000	0.6874	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	35382	COMPRESSAS DE GASES 7.5 X7,5 (11 FIOS ESTERIL) UN	0.0000	0.6000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.3500	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	51588	ESPARADRAPO MICROPORE 50 X 10 CM CM	0.0000	0.5100	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	53945	ACIDO ASCORBICO 500 MG CP VO UN	0.0000	0.5900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	01496	FENITOINA 50 MG/ML 5 ML SI IM IV AP	0.0000	2.3400	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	01496	FENITOINA 50 MG/ML 5 ML SI IM IV AP	0.0000	2.3400	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	01584	NEOSTIGMINA 0,5 MG/ML 1 ML SI IM IV SC AP	0.0000	0.7662	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	01584	NEOSTIGMINA 0,5 MG/ML 1 ML SI IM IV SC AP	0.0000	0.7662	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	01584	NEOSTIGMINA 0,5 MG/ML 1 ML SI IM IV SC AP	0.0000	0.7662	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00169	SORO GLICOSADO 5% 500 ML SI IV BS	0.0000	3.6715	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00171	SORO FISIOLOGICO 0,9% 250 ML SI IV BS	0.0000	3.9400	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	24082	BROMOPRIDA 5 MG/ML 2 ML SI IM IV AP	0.0000	2.7300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	24082	BROMOPRIDA 5 MG/ML 2 ML SI IM IV AP	0.0000	2.7300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	24082	BROMOPRIDA 5 MG/ML 2 ML SI IM IV AP	0.0000	2.7300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	24082	BROMOPRIDA 5 MG/ML 2 ML SI IM IV AP	0.0000	2.7300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	24082	BROMOPRIDA 5 MG/ML 2 ML SI IM IV AP	0.0000	2.7300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	26981	SORO FISIOLOGICO 0,9% 10 ML SI IV AP	0.0000	0.9600	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	26981	SORO FISIOLOGICO 0,9% 10 ML SI IV AP	0.0000	0.9600	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	26981	SORO FISIOLOGICO 0,9% 10 ML SI IV AP	0.0000	0.9600	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	26981	SORO FISIOLOGICO 0,9% 10 ML SI IV AP	0.0000	0.9600	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	ea4ad2636c25d8e3dbb569ae62db71e7	IONE	12489788840	NULL	12489788840	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1800	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	ea4ad2636c25d8e3dbb569ae62db71e7	IONE	12489788840	NULL	12489788840	00098	ABOCATH N 14 A 22 UN	0.0000	3.7700	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	d17b3c5ae418d82694895a326dee545a	ODILIA	12670516743	NULL	12670516743	102001	DIARIA DE APARTAMENTO	0.0000	288.8882	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	d17b3c5ae418d82694895a326dee545a	ODILIA	12670516743	NULL	12670516743	102001	DIARIA DE APARTAMENTO	0.0000	288.8882	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	d17b3c5ae418d82694895a326dee545a	ODILIA	12670516743	NULL	12670516743	00128	LUVA DE PROCEDIMENTO UNIDADE UN	0.0000	1.0000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	d17b3c5ae418d82694895a326dee545a	ODILIA	12670516743	NULL	12670516743	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	OPME INVALIDO	2201
Glosa Min	2018-10-03 00:00:00.000000	1084117	d17b3c5ae418d82694895a326dee545a	ODILIA	12670516743	NULL	12670516743	02197	METAMUCIL (PLANTAGO OVATA) 3,4 G PO VO EV	0.0000	2.4600	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	d17b3c5ae418d82694895a326dee545a	ODILIA	12670516743	NULL	12670516743	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	d17b3c5ae418d82694895a326dee545a	ODILIA	12670516743	NULL	12670516743	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	d17b3c5ae418d82694895a326dee545a	ODILIA	12670516743	NULL	12670516743	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	d17b3c5ae418d82694895a326dee545a	ODILIA	12670516743	NULL	12670516743	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.0000	0.6800	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1965b0cdebe9017c3397c8641147759	JOSE	12705413746	NULL	12705413746	102001	DIARIA DE APARTAMENTO	0.0000	288.8882	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1965b0cdebe9017c3397c8641147759	JOSE	12705413746	NULL	12705413746	102001	DIARIA DE APARTAMENTO	0.0000	288.8882	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1965b0cdebe9017c3397c8641147759	JOSE	12705413746	NULL	12705413746	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4074	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1965b0cdebe9017c3397c8641147759	JOSE	12705413746	NULL	12705413746	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1965b0cdebe9017c3397c8641147759	JOSE	12705413746	NULL	12705413746	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4074	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1965b0cdebe9017c3397c8641147759	JOSE	12705413746	NULL	12705413746	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4074	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1965b0cdebe9017c3397c8641147759	JOSE	12705413746	NULL	12705413746	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4074	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1965b0cdebe9017c3397c8641147759	JOSE	12705413746	NULL	12705413746	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4074	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4072	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	02246	HIDROCORTISONA 100 MG PO IM IV FA	0.0000	2.8300	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	02246	HIDROCORTISONA 100 MG PO IM IV FA	0.0000	2.8300	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	26981	SORO FISIOLOGICO 0,9% 10 ML SI IV AP	0.0000	0.4800	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	26981	SORO FISIOLOGICO 0,9% 10 ML SI IV AP	0.0000	0.4800	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	00404	LACTULOSE 667 MG/ML XP VO ML	0.0000	0.2100	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	00404	LACTULOSE 667 MG/ML XP VO ML	0.0000	6.4300	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	00404	LACTULOSE 667 MG/ML XP VO ML	0.0000	6.4300	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	00487	RANITIDINA 25 MG/ML 2 ML SI IM IV AP	0.0000	0.9300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	00487	RANITIDINA 25 MG/ML 2 ML SI IM IV AP	0.0000	0.9300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1771	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1771	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1771	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	081fdadb830fb547e83c43fabdb88372	ELZA	12377335349	NULL	12377335349	51240	FITA ADVANTAGE P/ GLICOSE UN	0.0000	5.1800	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	081fdadb830fb547e83c43fabdb88372	ELZA	12377335349	NULL	12377335349	09071	ACETILCISTEINA 600MG PO VO SA	0.0000	3.5000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	081fdadb830fb547e83c43fabdb88372	ELZA	12377335349	NULL	12377335349	09071	ACETILCISTEINA 600MG PO VO SA	0.0000	3.5000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	00172	SORO FISIOLOGICO 0,9% 500 ML SI IV BS	0.0000	9.4698	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	00172	SORO FISIOLOGICO 0,9% 500 ML SI IV BS	0.0000	9.4698	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	00172	SORO FISIOLOGICO 0,9% 500 ML SI IV BS	0.0000	9.4698	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	24571	CLINDAMICINA 600 MG 4 ML SI IM IV AP	0.0000	13.0800	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	24571	CLINDAMICINA 600 MG 4 ML SI IM IV AP	0.0000	13.0800	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	24571	CLINDAMICINA 600 MG 4 ML SI IM IV AP	0.0000	13.0800	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	24571	CLINDAMICINA 600 MG 4 ML SI IM IV AP	0.0000	13.0800	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	24571	CLINDAMICINA 600 MG 4 ML SI IM IV AP	0.0000	13.0800	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	24571	CLINDAMICINA 600 MG 4 ML SI IM IV AP	0.0000	13.0800	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	24571	CLINDAMICINA 600 MG 4 ML SI IM IV AP	0.0000	13.0800	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	24571	CLINDAMICINA 600 MG 4 ML SI IM IV AP	0.0000	13.0800	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	dd486d36a88cfef0b44fe652638a0164	DELFINA	12660326244	NULL	12660326244	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR APRESENTADO A MAIOR	1705
Glosa Min	2018-10-03 00:00:00.000000	1084117	dd486d36a88cfef0b44fe652638a0164	DELFINA	12660326244	NULL	12660326244	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	dd486d36a88cfef0b44fe652638a0164	DELFINA	12660326244	NULL	12660326244	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR APRESENTADO A MAIOR	1705
Glosa Min	2018-10-03 00:00:00.000000	1084117	dd486d36a88cfef0b44fe652638a0164	DELFINA	12660326244	NULL	12660326244	14191	OMEPRAZOL 20 MG CA VO UN	0.0000	0.9000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	dd486d36a88cfef0b44fe652638a0164	DELFINA	12660326244	NULL	12660326244	00406	FUROSEMIDA 10 MG/ML 2 ML SI IM IV AP	0.0000	0.6000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	dd486d36a88cfef0b44fe652638a0164	DELFINA	12660326244	NULL	12660326244	00406	FUROSEMIDA 10 MG/ML 2 ML SI IM IV AP	0.0000	0.6000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	dd486d36a88cfef0b44fe652638a0164	DELFINA	12660326244	NULL	12660326244	00487	RANITIDINA 25 MG/ML 2 ML SI IM IV AP	0.0000	0.9300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	dd486d36a88cfef0b44fe652638a0164	DELFINA	12660326244	NULL	12660326244	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.0000	0.8100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	dd486d36a88cfef0b44fe652638a0164	DELFINA	12660326244	NULL	12660326244	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.0000	0.8100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	dd486d36a88cfef0b44fe652638a0164	DELFINA	12660326244	NULL	12660326244	51241	AGULHA 123X45	0.0000	0.7700	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	dd486d36a88cfef0b44fe652638a0164	DELFINA	12660326244	NULL	12660326244	51379	SERINGA DESC 05 ML UN	0.0000	0.1900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	dd486d36a88cfef0b44fe652638a0164	DELFINA	12660326244	NULL	12660326244	51379	SERINGA DESC 05 ML UN	0.0000	0.1900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	dd486d36a88cfef0b44fe652638a0164	DELFINA	12660326244	NULL	12660326244	51379	SERINGA DESC 05 ML UN	0.0000	0.1900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	dd486d36a88cfef0b44fe652638a0164	DELFINA	12660326244	NULL	12660326244	51497	ESPIRONOLACTONA 50 MG + HIDROCLOROTIAZIDA 50 MG	0.0000	0.9800	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	dd486d36a88cfef0b44fe652638a0164	DELFINA	12660326244	NULL	12660326244	51497	ESPIRONOLACTONA 50 MG + HIDROCLOROTIAZIDA 50 MG	0.0000	0.9800	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	dd486d36a88cfef0b44fe652638a0164	DELFINA	12660326244	NULL	12660326244	51584	ESPARADRAPO MICROPORE	0.0000	0.2600	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	dd486d36a88cfef0b44fe652638a0164	DELFINA	12660326244	NULL	12660326244	51584	ESPARADRAPO MICROPORE	0.0000	0.7700	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	dd486d36a88cfef0b44fe652638a0164	DELFINA	12660326244	NULL	12660326244	51584	ESPARADRAPO MICROPORE	0.0000	0.7700	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	dd486d36a88cfef0b44fe652638a0164	DELFINA	12660326244	NULL	12660326244	51588	ESPARADRAPO MICROPORE 50 X 10 CM CM	0.0000	0.7700	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	dd486d36a88cfef0b44fe652638a0164	DELFINA	12660326244	NULL	12660326244	51589	ESPARADRAPO 10 X 4.5 CM CM	0.0000	0.4000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	dd486d36a88cfef0b44fe652638a0164	DELFINA	12660326244	NULL	12660326244	00541	AMIODARONA 200 MG CP VO UN	0.0000	0.8400	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	dd486d36a88cfef0b44fe652638a0164	DELFINA	12660326244	NULL	12660326244	06400	CARVEDILOL 3,125 MG CP VO UN	0.0000	0.7300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	102001	DIARIA DE APARTAMENTO	0.0000	288.8900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	11325	EQUIPO MACRO-GOTAS FLEXIVEL C/ INJETOR LATERAL UN	0.0000	3.1800	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	51649	ALCOOL ETILICO 70 % ST TP ML	0.0000	0.0300	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	51649	ALCOOL ETILICO 70 % ST TP ML	0.0000	0.0300	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	51649	ALCOOL ETILICO 70 % ST TP ML	0.0000	0.0300	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	51649	ALCOOL ETILICO 70 % ST TP ML	0.0000	0.0600	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	00090	SERINGA DESC 20 ML UN	0.0000	0.5400	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	00090	SERINGA DESC 20 ML UN	0.0000	0.5400	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	00090	SERINGA DESC 20 ML UN	0.0000	0.5400	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	00090	SERINGA DESC 20 ML UN	0.0000	0.5400	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	00919	ALGODAO HIDROFILO BOLINHA UN	0.0000	0.2600	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	00943	EQUIPO POLIFIX 2 VIAS UN	0.0000	2.5500	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	00943	EQUIPO POLIFIX 2 VIAS UN	0.0000	2.5500	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	f3ad474c8c562757c4d1a959ff0961c4	DJALMA	12718763240	NULL	12718763240	00124	LUVA CIRURGICA UN	0.0000	1.4500	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	f3ad474c8c562757c4d1a959ff0961c4	DJALMA	12718763240	NULL	12718763240	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	f3ad474c8c562757c4d1a959ff0961c4	DJALMA	12718763240	NULL	12718763240	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	f3ad474c8c562757c4d1a959ff0961c4	DJALMA	12718763240	NULL	12718763240	03280	CLOREXIDINA 2 % ST TP ML	0.0000	0.2700	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	f3ad474c8c562757c4d1a959ff0961c4	DJALMA	12718763240	NULL	12718763240	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1800	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	f3ad474c8c562757c4d1a959ff0961c4	DJALMA	12718763240	NULL	12718763240	00090	SERINGA DESC 20 ML UN	0.0000	0.5400	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	f3ad474c8c562757c4d1a959ff0961c4	DJALMA	12718763240	NULL	12718763240	00090	SERINGA DESC 20 ML UN	0.0000	0.5400	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	806bfa8e76209648a4ae145ff436d092	GILBERTO	12692620640	NULL	12692620640	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.0000	0.6875	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	806bfa8e76209648a4ae145ff436d092	GILBERTO	12692620640	NULL	12692620640	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.0000	0.6875	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	806bfa8e76209648a4ae145ff436d092	GILBERTO	12692620640	NULL	12692620640	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.0000	0.6875	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3fb5c891f31bb9efcb05395066127c52	ALAIDE	12636273441	NULL	12636273441	14250	PARACETAMOL 750 MG CP VO UN	0.0000	0.0000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00090	SERINGA DESC 20 ML UN	0.5400	0.2200	0.3200	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00090	SERINGA DESC 20 ML UN	0.5400	0.2200	0.3200	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00090	SERINGA DESC 20 ML UN	0.5400	0.2200	0.3200	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00090	SERINGA DESC 20 ML UN	0.5400	0.2200	0.3200	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.6900	0.2700	0.4200	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.6900	0.2700	0.4200	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.6900	0.2700	0.4200	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.6900	0.2700	0.4200	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.6900	0.2700	0.4200	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00128	LUVA DE PROCEDIMENTO UNIDADE UN	1.0000	0.3900	0.6100	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	56456	ZOLPIDEM 10 MG CP VO UN	1.2800	0.4900	0.7900	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00493	BROMOPRIDA 5 MG/ML 2 ML SI IM IV AP	2.7300	1.0600	1.6700	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00124	LUVA CIRURGICA UN	2.9000	1.1300	1.7700	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	51163	AGUA BIDESTILADA 250 ML	5.7900	2.2600	3.5300	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	52959	FIO MONONYLON 2-0 C/AGULHA 3,0 3/8 1215T EV	6.1700	2.4000	3.7700	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00404	LACTULOSE 667 MG/ML XP VO ML	6.4300	2.5100	3.9200	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00613	CLINDAMICINA 600 MG 4 ML SI IM IV AP	13.0800	5.1000	7.9800	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	16b1e9f62f247f02ad5cac910ee15b4e	BERCHOLINA	12631612848	NULL	12631612848	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4081	0.0019	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	16b1e9f62f247f02ad5cac910ee15b4e	BERCHOLINA	12631612848	NULL	12631612848	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4081	0.0019	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	16b1e9f62f247f02ad5cac910ee15b4e	BERCHOLINA	12631612848	NULL	12631612848	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4081	0.0019	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	16b1e9f62f247f02ad5cac910ee15b4e	BERCHOLINA	12631612848	NULL	12631612848	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4081	0.0019	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	16b1e9f62f247f02ad5cac910ee15b4e	BERCHOLINA	12631612848	NULL	12631612848	19160	SERINGA DESC 20 ML UN	0.5400	0.5386	0.0014	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	16b1e9f62f247f02ad5cac910ee15b4e	BERCHOLINA	12631612848	NULL	12631612848	33219	LUVA DE PROCEDIMENTO UNIDADE UN	0.8370	1.0018	-0.3318	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	16b1e9f62f247f02ad5cac910ee15b4e	BERCHOLINA	12631612848	NULL	12631612848	00090	SERINGA DESC 20 ML UN	0.5400	0.5200	0.0200	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	16b1e9f62f247f02ad5cac910ee15b4e	BERCHOLINA	12631612848	NULL	12631612848	00090	SERINGA DESC 20 ML UN	0.5400	0.5200	0.0200	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	16b1e9f62f247f02ad5cac910ee15b4e	BERCHOLINA	12631612848	NULL	12631612848	00171	SORO FISIOLOGICO 0,9% 250 ML SI IV BS	3.9400	3.7600	0.1800	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	01081195	b477554b2b27a1385e29647b9a3a0084	MARIA	12811135119	NULL	12811135119	00010014	CONSULTA EM CONSULTORIO MEDICO	0.0000	0.0000	50.0000	GUIA DE CONSULTA NAO EXECUTADA	0622
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12550571048	NULL	12550571048	37761	ALCOOL ETILICO 70 % ST TP ML	0.0300	0.0200	0.0100	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12550571048	NULL	12550571048	08648	ESPARADRAPO 10 X 4.5 CM CM	0.4000	0.2000	0.2000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12550571048	NULL	12550571048	53660	EQUIPO MACRO-GOTAS FLEXIVEL C/ INJETOR LATE	1.5900	0.0000	1.5900	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12550571048	NULL	12550571048	37761	ALCOOL ETILICO 70 % ST TP ML	0.0600	0.0200	0.0400	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12550571048	NULL	12550571048	08648	ESPARADRAPO 10 X 4.5 CM CM	0.4000	0.2000	0.2000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12550571048	NULL	12550571048	00817	ALGODAO HIDROFILO BOLINHA UN	0.5100	0.1300	0.3800	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	37761	ALCOOL ETILICO 70 % ST TP ML	0.0600	0.0300	0.0300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	00817	ALGODAO HIDROFILO BOLINHA UN	0.0500	0.0000	0.0500	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	00817	ALGODAO HIDROFILO BOLINHA UN	0.5100	0.2600	0.2500	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	52302	CLOREXIDINA SL TP BU ML	0.4200	0.0600	0.3600	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	37761	ALCOOL ETILICO 70 % ST TP ML	0.0600	0.0200	0.0400	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	75bcd473a0dc7c7a6751499b38a4a034	JOAQUIM	12692852143	NULL	12692852143	08664	ESPARADRAPO MICROPORE 50 X 10 CM CM	0.7700	0.0000	0.7700	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	75bcd473a0dc7c7a6751499b38a4a034	JOAQUIM	12692852143	NULL	12692852143	08648	ESPARADRAPO 10 X 4.5 CM CM	0.4000	0.1000	0.3000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	75bcd473a0dc7c7a6751499b38a4a034	JOAQUIM	12692852143	NULL	12692852143	08648	ESPARADRAPO 10 X 4.5 CM CM	0.4000	0.1000	0.3000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	4668d2494ed6c4b2d18be299efcb26a2	JOAO	12469689344	NULL	12469689344	11193	CLOREXIDINA 2 % ST TP ML	2.6600	1.8600	0.8000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	4668d2494ed6c4b2d18be299efcb26a2	JOAO	12469689344	NULL	12469689344	08648	ESPARADRAPO 10 X 4.5 CM CM	0.4000	0.2600	0.1400	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	4668d2494ed6c4b2d18be299efcb26a2	JOAO	12469689344	NULL	12469689344	08664	ESPARADRAPO MICROPORE 50 X 10 CM CM	0.7700	0.2600	0.5100	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	00817	ALGODAO HIDROFILO BOLINHA UN	0.5100	0.2600	0.2500	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	37761	ALCOOL ETILICO 70 % ST TP ML	0.0300	0.0200	0.0100	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	52582	CATETER OXIGENIO TIPO OCULOS UN	1.0000	0.0000	1.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	02461	FENOTEROL 2 MG/ML 10 ML AE IN DS	0.3400	0.0000	0.3400	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	30376	BROMETO DE IPRATROPIO 0,25MG/ML SL IN GT	0.6000	0.0000	0.6000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	33219	LUVA DE PROCEDIMENTO UNIDADE UN	0.6700	0.0000	0.6700	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	37761	ALCOOL ETILICO 70 % ST TP ML	0.0300	0.0200	0.0100	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	37761	ALCOOL ETILICO 70 % ST TP ML	0.0300	0.0200	0.0100	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	37761	ALCOOL ETILICO 70 % ST TP ML	0.0300	0.0200	0.0100	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	00817	ALGODAO HIDROFILO BOLINHA UN	0.2600	0.1300	0.1300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00035	ABOCATH (CATETER INTRAVENOSO) N. 14 A 22 UN	11.3000	3.7700	7.5300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	33219	LUVA DE PROCEDIMENTO UNIDADE UN	1.0000	0.6700	0.3300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	37761	ALCOOL ETILICO 70 % ST TP ML	0.0300	0.0200	0.0100	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	33219	LUVA DE PROCEDIMENTO UNIDADE UN	1.0000	0.6700	0.3300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	37761	ALCOOL ETILICO 70 % ST TP ML	0.0300	0.0200	0.0100	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	11193	CLOREXIDINA 2 % ST TP ML	0.8000	0.0000	0.8000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	08664	ESPARADRAPO MICROPORE 50 X 10 CM CM	0.7700	0.0000	0.7700	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	37761	ALCOOL ETILICO 70 % ST TP ML	0.0300	0.0200	0.0100	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	52582	CATETER OXIGENIO TIPO OCULOS UN	1.0000	0.0000	1.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	11193	CLOREXIDINA 2 % ST TP ML	0.8000	0.0000	0.8000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	22748	LIDOCAINA 2% GE TP OU GR	2.5900	1.3000	1.2900	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	33219	LUVA DE PROCEDIMENTO UNIDADE UN	1.0000	0.6700	0.3300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1965b0cdebe9017c3397c8641147759	JOSE	12705413746	NULL	12705413746	05975	COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER	0.9000	0.0000	0.9000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12558131243	NULL	12558131243	08664	ESPARADRAPO MICROPORE 50 X 10 CM CM	0.7700	0.2600	0.5100	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00817	ALGODAO HIDROFILO BOLINHA UN	0.2600	0.1300	0.1300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	37761	ALCOOL ETILICO 70 % ST TP ML	0.0300	0.0200	0.0100	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00817	ALGODAO HIDROFILO BOLINHA UN	0.2600	0.1300	0.1300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	7c2bc8cd9bbf9ce081562a3c63fff8c9	MARTA	12647505849	NULL	12647505849	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4000	0.0000	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	7c2bc8cd9bbf9ce081562a3c63fff8c9	MARTA	12647505849	NULL	12647505849	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1752	0.0048	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	7c2bc8cd9bbf9ce081562a3c63fff8c9	MARTA	12647505849	NULL	12647505849	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1756	0.0044	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	f65f553befc0e3bc8bd5bce5c1c6e413	NAIRLENE	12633078944	NULL	12633078944	19160	SERINGA DESC 20 ML UN	0.5400	0.5367	0.0033	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	f65f553befc0e3bc8bd5bce5c1c6e413	NAIRLENE	12633078944	NULL	12633078944	19160	SERINGA DESC 20 ML UN	0.5400	0.5367	0.0033	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	f65f553befc0e3bc8bd5bce5c1c6e413	NAIRLENE	12633078944	NULL	12633078944	19160	SERINGA DESC 20 ML UN	0.5400	0.5367	0.0033	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	f65f553befc0e3bc8bd5bce5c1c6e413	NAIRLENE	12633078944	NULL	12633078944	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4067	0.0033	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	f65f553befc0e3bc8bd5bce5c1c6e413	NAIRLENE	12633078944	NULL	12633078944	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4067	0.0033	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	f65f553befc0e3bc8bd5bce5c1c6e413	NAIRLENE	12633078944	NULL	12633078944	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4067	0.0033	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	f65f553befc0e3bc8bd5bce5c1c6e413	NAIRLENE	12633078944	NULL	12633078944	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4067	0.0033	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	f65f553befc0e3bc8bd5bce5c1c6e413	NAIRLENE	12633078944	NULL	12633078944	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1760	0.0040	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	f65f553befc0e3bc8bd5bce5c1c6e413	NAIRLENE	12633078944	NULL	12633078944	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1760	0.0040	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	f65f553befc0e3bc8bd5bce5c1c6e413	NAIRLENE	12633078944	NULL	12633078944	07269	DIPIRONA 500 MG/ML 2 ML SI IV IM AP	0.6900	0.6867	0.0033	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	c2bcdc3cbedb73a0db271ac09d4587a1	ORDETE	12694018147	NULL	12694018147	20567	SORO FISIOLOGICO 0,9% 500 ML SI IV BS	9.4700	9.4680	0.0020	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	026c6dcfddc3d74250c79f449289696a	SALOMAO	12456038443	NULL	12456038443	33219	LUVA DE PROCEDIMENTO UNIDADE UN	1.0000	0.9900	0.0000	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	026c6dcfddc3d74250c79f449289696a	SALOMAO	12456038443	NULL	12456038443	07269	DIPIRONA 500 MG/ML 2 ML SI IV IM AP	0.6900	0.6800	0.0000	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	026c6dcfddc3d74250c79f449289696a	SALOMAO	12456038443	NULL	12456038443	12262	ISOSSORBIDA 20 MG CP VO UN	0.2200	0.2150	0.0050	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	d4089ccef13567fd45b16fb0b60685fa	VERA	12640482546	NULL	12640482546	33219	LUVA DE PROCEDIMENTO UNIDADE UN	1.0000	0.9900	0.0000	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	d4089ccef13567fd45b16fb0b60685fa	VERA	12640482546	NULL	12640482546	27480	CLARITROMICINA 500 MG 30 ML PO IV FA	117.1100	117.1050	0.0050	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	d4089ccef13567fd45b16fb0b60685fa	VERA	12640482546	NULL	12640482546	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1748	0.0052	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	d4089ccef13567fd45b16fb0b60685fa	VERA	12640482546	NULL	12640482546	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1754	0.0046	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	d4089ccef13567fd45b16fb0b60685fa	VERA	12640482546	NULL	12640482546	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1754	0.0046	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	d4089ccef13567fd45b16fb0b60685fa	VERA	12640482546	NULL	12640482546	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1754	0.0046	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	d4089ccef13567fd45b16fb0b60685fa	VERA	12640482546	NULL	12640482546	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1754	0.0046	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	d4089ccef13567fd45b16fb0b60685fa	VERA	12640482546	NULL	12640482546	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1754	0.0046	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	d4089ccef13567fd45b16fb0b60685fa	VERA	12640482546	NULL	12640482546	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1754	0.0046	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	d4089ccef13567fd45b16fb0b60685fa	VERA	12640482546	NULL	12640482546	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1754	0.0046	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	d4089ccef13567fd45b16fb0b60685fa	VERA	12640482546	NULL	12640482546	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1754	0.0046	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	eecb3d883747b059c3fe231c34567476	AFFRIDES	12693180144	NULL	12693180144	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4074	0.0026	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	eecb3d883747b059c3fe231c34567476	AFFRIDES	12693180144	NULL	12693180144	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4074	0.0026	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	eecb3d883747b059c3fe231c34567476	AFFRIDES	12693180144	NULL	12693180144	19160	SERINGA DESC 20 ML UN	0.5400	0.5372	0.0028	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	eecb3d883747b059c3fe231c34567476	AFFRIDES	12693180144	NULL	12693180144	19160	SERINGA DESC 20 ML UN	0.5400	0.5372	0.0028	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	eecb3d883747b059c3fe231c34567476	AFFRIDES	12693180144	NULL	12693180144	19160	SERINGA DESC 20 ML UN	0.5400	0.5372	0.0028	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	eecb3d883747b059c3fe231c34567476	AFFRIDES	12693180144	NULL	12693180144	19160	SERINGA DESC 20 ML UN	0.5400	0.5372	0.0028	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	eecb3d883747b059c3fe231c34567476	AFFRIDES	12693180144	NULL	12693180144	19160	SERINGA DESC 20 ML UN	0.5400	0.5372	0.0028	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	eecb3d883747b059c3fe231c34567476	AFFRIDES	12693180144	NULL	12693180144	19160	SERINGA DESC 20 ML UN	0.5400	0.5372	0.0028	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1d6bbb4a00130e2e654e830fc9bae6a	ALEXANDRINA	12694224940	NULL	12694224940	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4072	0.0028	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1d6bbb4a00130e2e654e830fc9bae6a	ALEXANDRINA	12694224940	NULL	12694224940	19160	SERINGA DESC 20 ML UN	0.5400	0.5367	0.0033	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1d6bbb4a00130e2e654e830fc9bae6a	ALEXANDRINA	12694224940	NULL	12694224940	19160	SERINGA DESC 20 ML UN	0.5400	0.5367	0.0033	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1d6bbb4a00130e2e654e830fc9bae6a	ALEXANDRINA	12694224940	NULL	12694224940	19160	SERINGA DESC 20 ML UN	0.5400	0.5367	0.0033	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1d6bbb4a00130e2e654e830fc9bae6a	ALEXANDRINA	12694224940	NULL	12694224940	19160	SERINGA DESC 20 ML UN	0.5400	0.5367	0.0033	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1d6bbb4a00130e2e654e830fc9bae6a	ALEXANDRINA	12694224940	NULL	12694224940	19160	SERINGA DESC 20 ML UN	0.5400	0.5367	0.0033	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	345c226bfea274af1372d41b0305a6c8	ALTINO	12720257940	NULL	12720257940	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.1000	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	345c226bfea274af1372d41b0305a6c8	ALTINO	12720257940	NULL	12720257940	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.1000	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	345c226bfea274af1372d41b0305a6c8	ALTINO	12720257940	NULL	12720257940	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.1000	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.1038	-0.0038	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.1038	-0.0038	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.1038	-0.0038	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.1038	-0.0038	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	19160	SERINGA DESC 20 ML UN	0.5400	0.5378	0.0022	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1787	0.0013	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1797	0.0003	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1900	0.1797	0.0103	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	17906	PROTAMINA 1000 UI/ML 5 ML SI IV AP	16.3400	13.6200	2.7200	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12550571048	NULL	12550571048	05975	COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER	0.6000	0.0000	0.6000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12550571048	NULL	12550571048	05975	COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER	0.3000	0.0000	0.3000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12550571048	NULL	12550571048	05975	COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER	0.6000	0.0000	0.6000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12550571048	NULL	12550571048	05975	COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER	0.6000	0.1500	0.4500	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12550571048	NULL	12550571048	05975	COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER	0.3000	0.0000	0.3000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	b288bbcfb9aecab51bcb0dba62ca0059	IVONETE	12743730847	NULL	12743730847	20672	SORO RINGER SIMPLES 500 ML SI IV BS	5.9400	5.9300	0.0000	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	670141098c0309ac9be3db204bdc12cf	LEOSINA	12706525442	NULL	12706525442	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1767	0.0033	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	20cbe2e07b1dcd2b6af609a50df7ae80	LUCELENA	12690767849	NULL	12690767849	27480	CLARITROMICINA 500 MG 30 ML PO IV FA	117.1100	117.1050	0.0050	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	20cbe2e07b1dcd2b6af609a50df7ae80	LUCELENA	12690767849	NULL	12690767849	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1758	0.0042	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	20cbe2e07b1dcd2b6af609a50df7ae80	LUCELENA	12690767849	NULL	12690767849	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1758	0.0042	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	20cbe2e07b1dcd2b6af609a50df7ae80	LUCELENA	12690767849	NULL	12690767849	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1758	0.0042	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	20cbe2e07b1dcd2b6af609a50df7ae80	LUCELENA	12690767849	NULL	12690767849	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1758	0.0042	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	20cbe2e07b1dcd2b6af609a50df7ae80	LUCELENA	12690767849	NULL	12690767849	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1758	0.0042	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	20cbe2e07b1dcd2b6af609a50df7ae80	LUCELENA	12690767849	NULL	12690767849	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4084	0.0016	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	20cbe2e07b1dcd2b6af609a50df7ae80	LUCELENA	12690767849	NULL	12690767849	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4084	0.0016	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	20cbe2e07b1dcd2b6af609a50df7ae80	LUCELENA	12690767849	NULL	12690767849	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4084	0.0016	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	20cbe2e07b1dcd2b6af609a50df7ae80	LUCELENA	12690767849	NULL	12690767849	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4084	0.0016	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	20cbe2e07b1dcd2b6af609a50df7ae80	LUCELENA	12690767849	NULL	12690767849	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4084	0.0016	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	20cbe2e07b1dcd2b6af609a50df7ae80	LUCELENA	12690767849	NULL	12690767849	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4084	0.0016	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	20cbe2e07b1dcd2b6af609a50df7ae80	LUCELENA	12690767849	NULL	12690767849	19160	SERINGA DESC 20 ML UN	0.5400	0.5384	0.0016	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	20cbe2e07b1dcd2b6af609a50df7ae80	LUCELENA	12690767849	NULL	12690767849	19160	SERINGA DESC 20 ML UN	0.5400	0.5384	0.0016	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	20cbe2e07b1dcd2b6af609a50df7ae80	LUCELENA	12690767849	NULL	12690767849	19160	SERINGA DESC 20 ML UN	0.5400	0.5384	0.0016	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	20cbe2e07b1dcd2b6af609a50df7ae80	LUCELENA	12690767849	NULL	12690767849	19160	SERINGA DESC 20 ML UN	0.5400	0.5384	0.0016	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	20cbe2e07b1dcd2b6af609a50df7ae80	LUCELENA	12690767849	NULL	12690767849	19160	SERINGA DESC 20 ML UN	0.5400	0.5384	0.0016	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	20cbe2e07b1dcd2b6af609a50df7ae80	LUCELENA	12690767849	NULL	12690767849	19160	SERINGA DESC 20 ML UN	0.5400	0.5384	0.0016	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	32204	CLORETO DE SODIO 0,9% 10 ML SI IV AP	0.9600	0.4800	0.4800	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	02461	FENOTEROL 2 MG/ML 10 ML AE IN DS	0.4300	0.4300	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	19445	CLORETO DE POTASSIO 600 MG CA VO UN	0.4900	0.4867	0.0033	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4075	0.0025	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4075	0.0025	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	07269	DIPIRONA 500 MG/ML 2 ML SI IV IM AP	0.6900	0.6865	0.0035	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	07269	DIPIRONA 500 MG/ML 2 ML SI IV IM AP	0.6900	0.6865	0.0035	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	07269	DIPIRONA 500 MG/ML 2 ML SI IV IM AP	0.6900	0.6865	0.0035	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	07269	DIPIRONA 500 MG/ML 2 ML SI IV IM AP	0.6900	0.6865	0.0035	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	07269	DIPIRONA 500 MG/ML 2 ML SI IV IM AP	0.6900	0.6865	0.0035	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1769	0.0031	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1769	0.0031	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1769	0.0031	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1769	0.0031	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1769	0.0031	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1769	0.0031	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1769	0.0031	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00426	AGUA BIDESTILADA 10 ML SI IV IM AP	0.8100	0.8073	0.0027	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00426	AGUA BIDESTILADA 10 ML SI IV IM AP	0.8100	0.8073	0.0027	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	33227	LUVA CIRURGICA PAR UN	1.4500	1.4477	0.0023	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	19160	SERINGA DESC 20 ML UN	0.5400	0.5372	0.0028	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	19160	SERINGA DESC 20 ML UN	1.0800	1.0744	0.0056	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1779	0.0021	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1779	0.0021	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1779	0.0021	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1779	0.0021	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1779	0.0021	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1779	0.0021	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	00426	AGUA BIDESTILADA 10 ML SI IV IM AP	0.8100	0.8092	0.0008	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	08664	ESPARADRAPO MICROPORE 50 X 10 CM CM	0.2600	0.2558	0.0042	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	08664	ESPARADRAPO MICROPORE 50 X 10 CM CM	0.2600	0.2558	0.0042	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	08664	ESPARADRAPO MICROPORE 50 X 10 CM CM	0.2600	0.2558	0.0042	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	e2b254ce765be196b019032789d8f852	MARIA	12576216044	NULL	12576216044	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4078	0.0022	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	08664	ESPARADRAPO MICROPORE 50 X 10 CM CM	0.7700	0.2550	0.5150	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	19135	SERINGA DESC 03 ML UN	0.1500	0.0000	0.1500	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	19135	SERINGA DESC 03 ML UN	0.1500	0.1500	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	19135	SERINGA DESC 03 ML UN	0.3000	0.0000	0.3000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	37761	ALCOOL ETILICO 70 % ST TP ML	0.0300	0.0000	0.0300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	37761	ALCOOL ETILICO 70 % ST TP ML	0.0300	0.0200	0.0100	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	d17b3c5ae418d82694895a326dee545a	ODILIA	12670516743	NULL	12670516743	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1774	0.0026	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	d17b3c5ae418d82694895a326dee545a	ODILIA	12670516743	NULL	12670516743	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1774	0.0026	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	d17b3c5ae418d82694895a326dee545a	ODILIA	12670516743	NULL	12670516743	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1774	0.0026	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	d17b3c5ae418d82694895a326dee545a	ODILIA	12670516743	NULL	12670516743	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1774	0.0026	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	6ccea6ac8c216c032723aee73a9f81c9	PRISCILA	12662249242	NULL	12662249242	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4067	0.0033	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	6ccea6ac8c216c032723aee73a9f81c9	PRISCILA	12662249242	NULL	12662249242	20672	SORO RINGER SIMPLES 500 ML SI IV BS	5.9400	5.9375	0.0025	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	6ccea6ac8c216c032723aee73a9f81c9	PRISCILA	12662249242	NULL	12662249242	20672	SORO RINGER SIMPLES 500 ML SI IV BS	11.8800	11.8750	0.0050	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	6ccea6ac8c216c032723aee73a9f81c9	PRISCILA	12662249242	NULL	12662249242	19160	SERINGA DESC 20 ML UN	0.5400	0.5373	0.0027	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.1000	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.1000	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.1000	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.1000	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.1000	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.1000	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.1000	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.1000	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.1000	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.1000	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.1000	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.1000	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.1000	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.1000	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.1000	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1766	0.0034	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	33227	LUVA CIRURGICA PAR UN	1.4500	1.4476	0.0024	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	33227	LUVA CIRURGICA PAR UN	1.4500	1.4476	0.0024	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	19160	SERINGA DESC 20 ML UN	0.5400	0.5380	0.0020	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	19160	SERINGA DESC 20 ML UN	0.5400	0.5384	0.0016	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	19160	SERINGA DESC 20 ML UN	0.5400	0.5384	0.0016	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	19160	SERINGA DESC 20 ML UN	0.5400	0.5384	0.0016	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	19160	SERINGA DESC 20 ML UN	0.5400	0.5384	0.0016	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	19160	SERINGA DESC 20 ML UN	0.5400	0.5384	0.0016	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	19160	SERINGA DESC 20 ML UN	0.5400	0.5384	0.0016	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	32891	EQUIPO POLIFIX 2ş VIAS UN	2.5500	2.5500	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1776	0.0024	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1776	0.0024	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	00426	AGUA BIDESTILADA 10 ML SI IV IM AP	0.8100	0.8092	0.0008	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	11193	CLOREXIDINA 2 % ST TP ML	0.5300	0.5300	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	08435	EQUIPO P/ BOMBA DE INFUSAO ENTERAL / PARENT	20.2800	20.2800	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	08435	EQUIPO P/ BOMBA DE INFUSAO ENTERAL / PARENT	20.2800	20.2800	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	6799aa3de305405ab065aad5b599765c	VANIR	12700232345	NULL	12700232345	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1750	0.0050	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	6799aa3de305405ab065aad5b599765c	VANIR	12700232345	NULL	12700232345	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1750	0.0050	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	6799aa3de305405ab065aad5b599765c	VANIR	12700232345	NULL	12700232345	07269	DIPIRONA 500 MG/ML 2 ML SI IV IM AP	0.6900	0.6870	0.0030	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	0111beed375944f60c7ad4a7fd4874f8	WALDIR	12746025744	NULL	12746025744	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1778	0.0022	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	0111beed375944f60c7ad4a7fd4874f8	WALDIR	12746025744	NULL	12746025744	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1773	0.0027	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	0111beed375944f60c7ad4a7fd4874f8	WALDIR	12746025744	NULL	12746025744	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1773	0.0027	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	0111beed375944f60c7ad4a7fd4874f8	WALDIR	12746025744	NULL	12746025744	00426	AGUA BIDESTILADA 10 ML SI IV IM AP	0.8100	0.8074	0.0026	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	05975	COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER	0.3000	0.0000	0.3000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	29661	NOREPINEFRINA 2 MG/ML 4 ML SI IV AP	142.4500	142.4438	0.0063	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00426	AGUA BIDESTILADA 10 ML SI IV IM AP	0.8100	0.8079	0.0021	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00426	AGUA BIDESTILADA 10 ML SI IV IM AP	0.8100	0.8079	0.0021	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00426	AGUA BIDESTILADA 10 ML SI IV IM AP	0.8100	0.8079	0.0021	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00426	AGUA BIDESTILADA 10 ML SI IV IM AP	0.8100	0.8079	0.0021	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00426	AGUA BIDESTILADA 10 ML SI IV IM AP	0.8100	0.8079	0.0021	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	08435	EQUIPO P/ BOMBA DE INFUSAO ENTERAL / PARENT	20.2800	20.2775	0.0025	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	75bcd473a0dc7c7a6751499b38a4a034	JOAQUIM	12692852143	NULL	12692852143	00817	ALGODAO HIDROFILO BOLINHA UN	0.2600	0.1300	0.1300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	610c198ec4c064687cf0524f147d3aed	ROBERTO	12748814743	NULL	12748814743	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1780	0.0020	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	610c198ec4c064687cf0524f147d3aed	ROBERTO	12748814743	NULL	12748814743	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1767	0.0033	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	610c198ec4c064687cf0524f147d3aed	ROBERTO	12748814743	NULL	12748814743	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1767	0.0033	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	610c198ec4c064687cf0524f147d3aed	ROBERTO	12748814743	NULL	12748814743	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1767	0.0033	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	610c198ec4c064687cf0524f147d3aed	ROBERTO	12748814743	NULL	12748814743	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4083	0.0017	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12647284040	NULL	12647284040	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1750	0.0050	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12647284040	NULL	12647284040	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1750	0.0050	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12647284040	NULL	12647284040	08664	ESPARADRAPO MICROPORE 50 X 10 CM CM	0.7700	0.7664	0.0036	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12647284040	NULL	12647284040	08664	ESPARADRAPO MICROPORE 50 X 10 CM CM	0.7700	0.7667	0.0033	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12647284040	NULL	12647284040	20567	SORO FISIOLOGICO 0,9% 500 ML SI IV BS	9.4700	9.4697	0.0003	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12647284040	NULL	12647284040	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4086	0.0014	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12647284040	NULL	12647284040	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4086	0.0014	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00817	ALGODAO HIDROFILO BOLINHA UN	0.2600	0.1300	0.1300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	08664	ESPARADRAPO MICROPORE 50 X 10 CM CM	0.2600	0.0000	0.2600	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	08664	ESPARADRAPO MICROPORE 50 X 10 CM CM	0.2600	0.0000	0.2600	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	33588	CLORETO DE SODIO 20% 10 ML SI IV AP	1.1000	1.1250	-0.0250	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	33545	PIPERACILINA 4 G + TAZOBACTAM 500 MG PO IV	83.4500	83.4500	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	33545	PIPERACILINA 4 G + TAZOBACTAM 500 MG PO IV	83.4500	83.4500	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	33545	PIPERACILINA 4 G + TAZOBACTAM 500 MG PO IV	83.4500	83.4500	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	33545	PIPERACILINA 4 G + TAZOBACTAM 500 MG PO IV	83.4500	83.4500	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	33545	PIPERACILINA 4 G + TAZOBACTAM 500 MG PO IV	83.4500	83.4500	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	6.8145	-3.4045	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	6.8145	-3.4045	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	6.8145	-3.4045	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	6.8145	-3.4045	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4072	0.0028	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4072	0.0028	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4072	0.0028	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4072	0.0028	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4072	0.0028	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	33227	LUVA CIRURGICA PAR UN	2.9000	2.9000	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.2120	-0.1120	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.2120	-0.1120	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	19160	SERINGA DESC 20 ML UN	0.5400	0.5374	0.0026	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	19160	SERINGA DESC 20 ML UN	0.5400	0.5374	0.0026	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	19160	SERINGA DESC 20 ML UN	0.5400	0.5374	0.0026	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	19160	SERINGA DESC 20 ML UN	0.5400	0.5374	0.0026	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	19160	SERINGA DESC 20 ML UN	0.5400	0.5374	0.0026	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	19160	SERINGA DESC 20 ML UN	0.5400	0.5374	0.0026	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1786	0.0014	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00426	AGUA BIDESTILADA 10 ML SI IV IM AP	0.4000	0.4037	-0.0037	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00426	AGUA BIDESTILADA 10 ML SI IV IM AP	0.4000	0.4037	-0.0037	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00426	AGUA BIDESTILADA 10 ML SI IV IM AP	0.4000	0.4037	-0.0037	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00426	AGUA BIDESTILADA 10 ML SI IV IM AP	0.4000	0.4037	-0.0037	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00426	AGUA BIDESTILADA 10 ML SI IV IM AP	0.4000	0.4037	-0.0037	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00426	AGUA BIDESTILADA 10 ML SI IV IM AP	0.8100	0.8073	0.0027	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00426	AGUA BIDESTILADA 10 ML SI IV IM AP	0.8100	0.8073	0.0027	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00426	AGUA BIDESTILADA 10 ML SI IV IM AP	0.8100	0.8073	0.0027	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00426	AGUA BIDESTILADA 10 ML SI IV IM AP	0.8100	0.8073	0.0027	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	13757	IODOPOVIDONA SD TP ML	0.4000	0.4000	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	13757	IODOPOVIDONA SD TP ML	0.4000	0.4000	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	09636	FLORATIL (SACCHAROMYCES BOULARDII) 200 MG P	4.4400	8.8851	-4.4451	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	09636	FLORATIL (SACCHAROMYCES BOULARDII) 200 MG P	4.4400	8.8851	-4.4451	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	19445	CLORETO DE POTASSIO 600 MG CA VO UN	1.4637	1.9474	-1.4574	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	05975	COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER	1.3439	1.3948	-0.7948	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	28959	DERSANI LC TP ML	12.6100	13.5800	-3.8800	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	55018	ALGINATO DE CALCIO EM HIDROGEL GL TP GR	3.4500	3.4500	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	08664	ESPARADRAPO MICROPORE 50 X 10 CM CM	1.3564	1.3849	-0.8749	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	08664	ESPARADRAPO MICROPORE 50 X 10 CM CM	1.3564	1.3849	-0.8749	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	08664	ESPARADRAPO MICROPORE 50 X 10 CM CM	1.3564	1.3849	-0.8749	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1d6bbb4a00130e2e654e830fc9bae6a	ALEXANDRINA	12694224940	NULL	12694224940	05274	AMOXICILINA 500 MG + CLAVULANATO 125 MG CP	3.1700	3.1667	0.0033	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	03280	CLOREXIDINA 2 % ST TP ML	NULL	0.0000	NULL	OPME INVALIDO	2201
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	03280	CLOREXIDINA 2 % ST TP ML	NULL	0.0000	NULL	OPME INVALIDO	2201
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	03280	CLOREXIDINA 2 % ST TP ML	NULL	0.0000	NULL	OPME INVALIDO	2201
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	51584	ESPARADRAPO MICROPORE	NULL	0.0000	NULL	OPME INVALIDO	2201
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	51584	ESPARADRAPO MICROPORE	NULL	0.0000	NULL	OPME INVALIDO	2201
Glosa Min	2018-10-03 00:00:00.000000	1084117	800720d33fe0defb6121e82dd216d044	JALMO	12786952647	NULL	12786952647	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1800	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	800720d33fe0defb6121e82dd216d044	JALMO	12786952647	NULL	12786952647	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1800	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	800720d33fe0defb6121e82dd216d044	JALMO	12786952647	NULL	12786952647	53973	Kit Protese Hibrida De Quadril Primaria	0.0000	0.2400	NULL	OPME PAGO A FORNECEDOR TERCEIRIZADO	2213
Glosa Min	2018-10-03 00:00:00.000000	1084117	800720d33fe0defb6121e82dd216d044	JALMO	12786952647	NULL	12786952647	00757	CEFUROXIMA 750 MG + DIL. 6 ML PO IM IV FA	0.0000	26.1300	NULL	VALOR APRESENTADO A MAIOR	1705
Glosa Min	2018-10-03 00:00:00.000000	1084117	800720d33fe0defb6121e82dd216d044	JALMO	12786952647	NULL	12786952647	00090	SERINGA DESC 20 ML UN	0.0000	0.5400	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	800720d33fe0defb6121e82dd216d044	JALMO	12786952647	NULL	12786952647	00090	SERINGA DESC 20 ML UN	0.0000	0.5400	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	752c651cb4fd049e19c685f87fbe8bdc	EDUARDO	12765990646	NULL	12765990646	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.0000	0.6875	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	752c651cb4fd049e19c685f87fbe8bdc	EDUARDO	12765990646	NULL	12765990646	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.0000	0.6875	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	752c651cb4fd049e19c685f87fbe8bdc	EDUARDO	12765990646	NULL	12765990646	51163	AGUA BIDESTILADA 250 ML	0.0000	3.3900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	752c651cb4fd049e19c685f87fbe8bdc	EDUARDO	12765990646	NULL	12765990646	51241	AGULHA 123X45	0.0000	0.1900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	752c651cb4fd049e19c685f87fbe8bdc	EDUARDO	12765990646	NULL	12765990646	51671	REPARIL (ESCINA + DIETILAMONIO) GL TP GR	0.0000	0.7400	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12558131243	NULL	12558131243	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1757	NULL	VALOR APRESENTADO A MAIOR	1705
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12558131243	NULL	12558131243	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1757	NULL	VALOR APRESENTADO A MAIOR	1705
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12558131243	NULL	12558131243	52010511	Fratura do Cóccix - Tratamento Cruento	0.0000	0.0000	NULL	COBRANCA DE HONORARIOS EM DUPLICIDADE	2607
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12558131243	NULL	12558131243	52250091	Retirada de Enxerto Ósseo	0.0000	0.0000	NULL	COBRANCA DE HONORARIOS EM DUPLICIDADE	2607
Glosa Min	2018-10-03 00:00:00.000000	1084117	526685c1041cc1316e874a2e95e67e2e	JOSE	12696604949	NULL	12696604949	51649	ALCOOL ETILICO 70 % ST TP ML	0.0000	0.1800	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	526685c1041cc1316e874a2e95e67e2e	JOSE	12696604949	NULL	12696604949	00090	SERINGA DESC 20 ML UN	0.0000	0.5367	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	526685c1041cc1316e874a2e95e67e2e	JOSE	12696604949	NULL	12696604949	00090	SERINGA DESC 20 ML UN	0.0000	0.5400	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	526685c1041cc1316e874a2e95e67e2e	JOSE	12696604949	NULL	12696604949	00090	SERINGA DESC 20 ML UN	0.0000	0.5367	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	11700	EQUIPO P/ BOMBA DE INFUSAO ENTERAL / PARENTERAL	0.0000	20.2800	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00404	LACTULOSE 667 MG/ML XP VO ML	0.0000	4.2900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.0000	0.0000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.0000	0.4000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.0000	0.4000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.0000	0.4000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	51163	AGUA BIDESTILADA 250 ML	0.0000	5.7900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	51163	AGUA BIDESTILADA 250 ML	0.0000	5.7900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	51164	AGUA BIDESTILADA 500 ML	0.0000	6.4300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.0000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	51379	SERINGA DESC 05 ML UN	0.0000	0.1900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	51434	BECLOMETASONA 400 MCG / ML 2 ML SL IN FL	0.0000	4.4800	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	51434	BECLOMETASONA 400 MCG / ML 2 ML SL IN FL	0.0000	4.4800	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00613	CLINDAMICINA 600 MG 4 ML SI IM IV AP	0.0000	13.0800	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00091	SERINGA DESC 01 ML (INSULINA) UN	0.0000	0.3057	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	0.0000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.0000	0.6900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	4e13adf421809cb755e1bdd80cc4efed	AGRIPINA	12385409142	NULL	12385409142	102001	DIARIA DE APARTAMENTO	0.0000	288.8800	NULL	VALOR APRESENTADO A MAIOR	1705
Glosa Min	2018-10-03 00:00:00.000000	1084117	4e13adf421809cb755e1bdd80cc4efed	AGRIPINA	12385409142	NULL	12385409142	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	4e13adf421809cb755e1bdd80cc4efed	AGRIPINA	12385409142	NULL	12385409142	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	4e13adf421809cb755e1bdd80cc4efed	AGRIPINA	12385409142	NULL	12385409142	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.0000	1.3700	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	4e13adf421809cb755e1bdd80cc4efed	AGRIPINA	12385409142	NULL	12385409142	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.0000	0.4000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	4e13adf421809cb755e1bdd80cc4efed	AGRIPINA	12385409142	NULL	12385409142	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.0000	0.4000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	75bcd473a0dc7c7a6751499b38a4a034	JOAQUIM	12692852143	NULL	12692852143	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4075	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	75bcd473a0dc7c7a6751499b38a4a034	JOAQUIM	12692852143	NULL	12692852143	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4075	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	75bcd473a0dc7c7a6751499b38a4a034	JOAQUIM	12692852143	NULL	12692852143	01652	TRAMADOL 50 MG CP VO UN	0.0000	1.9272	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	75bcd473a0dc7c7a6751499b38a4a034	JOAQUIM	12692852143	NULL	12692852143	01652	TRAMADOL 50 MG CP VO UN	0.0000	1.9272	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	75bcd473a0dc7c7a6751499b38a4a034	JOAQUIM	12692852143	NULL	12692852143	01652	TRAMADOL 50 MG CP VO UN	0.0000	1.9272	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	75bcd473a0dc7c7a6751499b38a4a034	JOAQUIM	12692852143	NULL	12692852143	01652	TRAMADOL 50 MG CP VO UN	0.0000	1.9272	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	75bcd473a0dc7c7a6751499b38a4a034	JOAQUIM	12692852143	NULL	12692852143	00172	SORO FISIOLOGICO 0,9% 500 ML SI IV BS	0.0000	4.7300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	75bcd473a0dc7c7a6751499b38a4a034	JOAQUIM	12692852143	NULL	12692852143	00172	SORO FISIOLOGICO 0,9% 500 ML SI IV BS	0.0000	3.2400	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	75bcd473a0dc7c7a6751499b38a4a034	JOAQUIM	12692852143	NULL	12692852143	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.0000	0.6850	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	75bcd473a0dc7c7a6751499b38a4a034	JOAQUIM	12692852143	NULL	12692852143	04073	TRAMADOL 50 MG 1 ML SI IM IV AP	0.0000	4.1900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	75bcd473a0dc7c7a6751499b38a4a034	JOAQUIM	12692852143	NULL	12692852143	04073	TRAMADOL 50 MG 1 ML SI IM IV AP	0.0000	4.1900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	75bcd473a0dc7c7a6751499b38a4a034	JOAQUIM	12692852143	NULL	12692852143	04073	TRAMADOL 50 MG 1 ML SI IM IV AP	0.0000	4.1900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	75bcd473a0dc7c7a6751499b38a4a034	JOAQUIM	12692852143	NULL	12692852143	51649	ALCOOL ETILICO 70 % ST TP ML	0.0000	0.0000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	75bcd473a0dc7c7a6751499b38a4a034	JOAQUIM	12692852143	NULL	12692852143	51710	CLORETO DE POTASSIO 15% 10 ML SI IV AP	0.0000	0.6850	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00124	LUVA CIRURGICA UN	0.0000	1.4475	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00124	LUVA CIRURGICA UN	0.0000	1.4475	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	26981	SORO FISIOLOGICO 0,9% 10 ML SI IV AP	0.0000	0.9600	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	26981	SORO FISIOLOGICO 0,9% 10 ML SI IV AP	0.0000	0.9600	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	26981	SORO FISIOLOGICO 0,9% 10 ML SI IV AP	0.0000	0.9600	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	26981	SORO FISIOLOGICO 0,9% 10 ML SI IV AP	0.0000	0.9600	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.0000	0.6875	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.0000	0.6875	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00487	RANITIDINA 25 MG/ML 2 ML SI IM IV AP	0.0000	0.9300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00487	RANITIDINA 25 MG/ML 2 ML SI IM IV AP	0.0000	0.9300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00487	RANITIDINA 25 MG/ML 2 ML SI IM IV AP	0.0000	0.9300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	51578	Frasco p/ alimentacao enteral	0.0000	2.4700	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	51584	ESPARADRAPO MICROPORE	0.0000	0.2560	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	54756	HIDANTAL	0.0000	0.1864	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	54756	HIDANTAL	0.0000	0.1864	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00796	FLORATIL (SACCHAROMYCES BOULARDII) 200 MG PO VO	0.0000	4.4400	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4088	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4088	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4088	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4088	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4088	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.0000	0.6900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.0000	0.6880	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.0000	0.6900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.0000	0.6872	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.0000	0.6872	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.0000	0.6872	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.0000	0.6872	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1766	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1766	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1766	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1766	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4070	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4070	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4070	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.0000	0.4000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	51508	ENCRISE (ARGIPRESSINA) 20 U/ML 1 ML SI IM IV SC AP	0.0000	20.1200	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	51584	ESPARADRAPO MICROPORE	0.0000	0.2560	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	51584	ESPARADRAPO MICROPORE	0.0000	0.2560	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	cd2840524be5a3f1d0939f241e24f32b	MARIA	12705908340	NULL	12705908340	00181	SULFATO DE MAGNESIO 100 MG/ML 10 ML SI IM IV	0.0000	0.9467	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	cd2840524be5a3f1d0939f241e24f32b	MARIA	12705908340	NULL	12705908340	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	cd2840524be5a3f1d0939f241e24f32b	MARIA	12705908340	NULL	12705908340	00090	SERINGA DESC 20 ML UN	0.0000	0.5365	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	cd2840524be5a3f1d0939f241e24f32b	MARIA	12705908340	NULL	12705908340	00090	SERINGA DESC 20 ML UN	0.0000	0.5367	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12550571048	NULL	12550571048	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1775	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12550571048	NULL	12550571048	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1775	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12550571048	NULL	12550571048	00090	SERINGA DESC 20 ML UN	0.0000	0.5379	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12550571048	NULL	12550571048	00090	SERINGA DESC 20 ML UN	0.0000	0.5400	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12550571048	NULL	12550571048	00090	SERINGA DESC 20 ML UN	0.0000	0.5379	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	9ffbbf7340bbd65e9e3baa9406d027f3	MARCO	12261811645	NULL	12261811645	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	9ffbbf7340bbd65e9e3baa9406d027f3	MARCO	12261811645	NULL	12261811645	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	9ffbbf7340bbd65e9e3baa9406d027f3	MARCO	12261811645	NULL	12261811645	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	9ffbbf7340bbd65e9e3baa9406d027f3	MARCO	12261811645	NULL	12261811645	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	9ffbbf7340bbd65e9e3baa9406d027f3	MARCO	12261811645	NULL	12261811645	01611	CLORETO DE POTASSIO 600 MG CA VO UN	0.0000	0.4867	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	9ffbbf7340bbd65e9e3baa9406d027f3	MARCO	12261811645	NULL	12261811645	01611	CLORETO DE POTASSIO 600 MG CA VO UN	0.0000	0.4867	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	9ffbbf7340bbd65e9e3baa9406d027f3	MARCO	12261811645	NULL	12261811645	01611	CLORETO DE POTASSIO 600 MG CA VO UN	0.0000	0.4867	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	9ffbbf7340bbd65e9e3baa9406d027f3	MARCO	12261811645	NULL	12261811645	26981	SORO FISIOLOGICO 0,9% 10 ML SI IV AP	0.0000	0.4800	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	9ffbbf7340bbd65e9e3baa9406d027f3	MARCO	12261811645	NULL	12261811645	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.0000	0.8078	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	9ffbbf7340bbd65e9e3baa9406d027f3	MARCO	12261811645	NULL	12261811645	51208	SORO RINGER SIMPLES 500 ML SI IV BS	0.0000	11.8800	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	9ffbbf7340bbd65e9e3baa9406d027f3	MARCO	12261811645	NULL	12261811645	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1773	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	9ffbbf7340bbd65e9e3baa9406d027f3	MARCO	12261811645	NULL	12261811645	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1773	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	9ffbbf7340bbd65e9e3baa9406d027f3	MARCO	12261811645	NULL	12261811645	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1773	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	9ffbbf7340bbd65e9e3baa9406d027f3	MARCO	12261811645	NULL	12261811645	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1773	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	9ffbbf7340bbd65e9e3baa9406d027f3	MARCO	12261811645	NULL	12261811645	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1773	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	9ffbbf7340bbd65e9e3baa9406d027f3	MARCO	12261811645	NULL	12261811645	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1773	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	9ffbbf7340bbd65e9e3baa9406d027f3	MARCO	12261811645	NULL	12261811645	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1773	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	9ffbbf7340bbd65e9e3baa9406d027f3	MARCO	12261811645	NULL	12261811645	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1773	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	9ffbbf7340bbd65e9e3baa9406d027f3	MARCO	12261811645	NULL	12261811645	00090	SERINGA DESC 20 ML UN	0.0000	0.5400	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	9ffbbf7340bbd65e9e3baa9406d027f3	MARCO	12261811645	NULL	12261811645	00090	SERINGA DESC 20 ML UN	0.0000	0.5400	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4094	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4094	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4094	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4094	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4094	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	01496	FENITOINA 50 MG/ML 5 ML SI IM IV AP	0.0000	2.3400	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	02246	HIDROCORTISONA 100 MG PO IM IV FA	0.0000	2.8300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	02246	HIDROCORTISONA 100 MG PO IM IV FA	0.0000	2.8300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	02246	HIDROCORTISONA 100 MG PO IM IV FA	0.0000	2.8300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	26981	SORO FISIOLOGICO 0,9% 10 ML SI IV AP	0.0000	0.4800	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	26981	SORO FISIOLOGICO 0,9% 10 ML SI IV AP	0.0000	0.4800	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	26981	SORO FISIOLOGICO 0,9% 10 ML SI IV AP	0.0000	0.9600	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	26981	SORO FISIOLOGICO 0,9% 10 ML SI IV AP	0.0000	0.9600	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	26981	SORO FISIOLOGICO 0,9% 10 ML SI IV AP	0.0000	0.9600	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	26981	SORO FISIOLOGICO 0,9% 10 ML SI IV AP	0.0000	0.9600	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	52392	SONDA DE ASPIRAÇAO TRAQUEAL C/ VALVULA UN	0.0000	0.9400	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	09070	ACETILCISTEINA 600MG PO VO SA	0.0000	3.4950	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	09070	ACETILCISTEINA 600MG PO VO SA	0.0000	3.4950	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	09070	ACETILCISTEINA 600MG PO VO SA	0.0000	3.4950	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	15f461c0ca379f375bd9f8b18fbb101a	ANA	12753753845	NULL	12753753845	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR APRESENTADO A MAIOR	1705
Glosa Min	2018-10-03 00:00:00.000000	1084117	15f461c0ca379f375bd9f8b18fbb101a	ANA	12753753845	NULL	12753753845	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR APRESENTADO A MAIOR	1705
Glosa Min	2018-10-03 00:00:00.000000	1084117	15f461c0ca379f375bd9f8b18fbb101a	ANA	12753753845	NULL	12753753845	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1800	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	15f461c0ca379f375bd9f8b18fbb101a	ANA	12753753845	NULL	12753753845	55279	TRAMADOL 50 MG 1 ML SI IM IV AP	0.0000	4.1900	NULL	COBRANCA DE MEDICAMENTO INCOMPATIVEL COM O RELATORIO TECNICO	2112
Glosa Min	2018-10-03 00:00:00.000000	1084117	15f461c0ca379f375bd9f8b18fbb101a	ANA	12753753845	NULL	12753753845	00657	CEFAZOLINA 1 GR + DIL. 10 ML PO IM IV FA	0.0000	8.1300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00124	LUVA CIRURGICA UN	0.0000	1.4475	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4072	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4072	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4072	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4072	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4072	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4072	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4072	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4072	NULL	VALOR APRESENTADO A MAIOR	1705
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4072	NULL	VALOR APRESENTADO A MAIOR	1705
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4072	NULL	VALOR APRESENTADO A MAIOR	1705
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	02355	AMOXICILINA 1 G + CLAVULANATO 200 MG + DIL. 10 ML	0.0000	36.4667	NULL	COBRANCA DE MEDICAMENTO EM QUANTIDADE INCOMPATIVEL COM A PERMANENCIA	2107
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	02355	AMOXICILINA 1 G + CLAVULANATO 200 MG + DIL. 10 ML	0.0000	36.4667	NULL	COBRANCA DE MEDICAMENTO EM QUANTIDADE INCOMPATIVEL COM A PERMANENCIA	2107
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	02355	AMOXICILINA 1 G + CLAVULANATO 200 MG + DIL. 10 ML	0.0000	36.4667	NULL	COBRANCA DE MEDICAMENTO EM QUANTIDADE INCOMPATIVEL COM A PERMANENCIA	2107
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	02355	AMOXICILINA 1 G + CLAVULANATO 200 MG + DIL. 10 ML	0.0000	36.4667	NULL	COBRANCA DE MEDICAMENTO EM QUANTIDADE INCOMPATIVEL COM A PERMANENCIA	2107
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	02355	AMOXICILINA 1 G + CLAVULANATO 200 MG + DIL. 10 ML	0.0000	36.4667	NULL	COBRANCA DE MEDICAMENTO EM QUANTIDADE INCOMPATIVEL COM A PERMANENCIA	2107
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00090	SERINGA DESC 20 ML UN	0.0000	0.5367	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00090	SERINGA DESC 20 ML UN	0.0000	0.5367	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00090	SERINGA DESC 20 ML UN	0.0000	0.5400	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00090	SERINGA DESC 20 ML UN	0.0000	0.5367	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00090	SERINGA DESC 20 ML UN	0.0000	0.5367	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00090	SERINGA DESC 20 ML UN	0.0000	1.0733	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	2e6b6f291f2df9beb1fbda6028678909	ANNA	12463693448	NULL	12463693448	00184	CLORETO DE POTASSIO 10% 10 ML SI IV AP	0.0000	0.3000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	2e6b6f291f2df9beb1fbda6028678909	ANNA	12463693448	NULL	12463693448	00184	CLORETO DE POTASSIO 10% 10 ML SI IV AP	0.0000	0.3000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	2e6b6f291f2df9beb1fbda6028678909	ANNA	12463693448	NULL	12463693448	20010141	Ecocardiograma Bidimensional com Mapeamento de Fluxo à Cores	0.0000	0.0000	NULL	OPME PAGO A FORNECEDOR TERCEIRIZADO	2213
Glosa Min	2018-10-03 00:00:00.000000	1084117	2e6b6f291f2df9beb1fbda6028678909	ANNA	12463693448	NULL	12463693448	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1800	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	2e6b6f291f2df9beb1fbda6028678909	ANNA	12463693448	NULL	12463693448	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1800	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	2e6b6f291f2df9beb1fbda6028678909	ANNA	12463693448	NULL	12463693448	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1800	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	31d18d6607d9e742c53e748d6a55d740	CARLOS	12557779343	NULL	12557779343	101001	DIARIA DE ENFERMARIA	0.0000	173.3200	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	11325	EQUIPO MACRO-GOTAS FLEXIVEL C/ INJETOR LATERAL UN	0.0000	1.5900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	11325	EQUIPO MACRO-GOTAS FLEXIVEL C/ INJETOR LATERAL UN	0.0000	1.5900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00124	LUVA CIRURGICA UN	0.0000	1.4478	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00124	LUVA CIRURGICA UN	0.0000	1.4478	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.0000	0.6871	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.0000	0.6871	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.0000	0.6871	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.0000	0.6871	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	35382	COMPRESSAS DE GASES 7.5 X7,5 (11 FIOS ESTERIL) UN	0.0000	0.3000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	35382	COMPRESSAS DE GASES 7.5 X7,5 (11 FIOS ESTERIL) UN	0.0000	0.6000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	35382	COMPRESSAS DE GASES 7.5 X7,5 (11 FIOS ESTERIL) UN	0.0000	0.6000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	35382	COMPRESSAS DE GASES 7.5 X7,5 (11 FIOS ESTERIL) UN	0.0000	0.6000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00487	RANITIDINA 25 MG/ML 2 ML SI IM IV AP	0.0000	0.9300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00487	RANITIDINA 25 MG/ML 2 ML SI IM IV AP	0.0000	0.9300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.0000	0.4000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.0000	0.4000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.0000	0.4000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.0000	0.4000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.0000	0.4000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1776	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1776	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	51379	SERINGA DESC 05 ML UN	0.0000	0.1900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	52392	SONDA DE ASPIRAÇAO TRAQUEAL C/ VALVULA UN	0.0000	1.8700	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	53774	SULFATO DE POLIMIXINA B GENERICO Restrito Hosp.	0.0000	11.8624	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	54157	EQUIPO P/ DIETA ENTERAL UN	0.0000	1.7000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	54157	EQUIPO P/ DIETA ENTERAL UN	0.0000	1.7000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00090	SERINGA DESC 20 ML UN	0.0000	0.5375	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00090	SERINGA DESC 20 ML UN	0.0000	0.5375	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00090	SERINGA DESC 20 ML UN	0.0000	0.5375	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1965b0cdebe9017c3397c8641147759	JOSE	12705413746	NULL	12705413746	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.0000	0.8074	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1965b0cdebe9017c3397c8641147759	JOSE	12705413746	NULL	12705413746	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.0000	0.8100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1965b0cdebe9017c3397c8641147759	JOSE	12705413746	NULL	12705413746	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.0000	0.8074	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1965b0cdebe9017c3397c8641147759	JOSE	12705413746	NULL	12705413746	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.0000	0.8074	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1965b0cdebe9017c3397c8641147759	JOSE	12705413746	NULL	12705413746	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.0000	0.8074	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1965b0cdebe9017c3397c8641147759	JOSE	12705413746	NULL	12705413746	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.0000	0.8074	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1965b0cdebe9017c3397c8641147759	JOSE	12705413746	NULL	12705413746	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1775	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1965b0cdebe9017c3397c8641147759	JOSE	12705413746	NULL	12705413746	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1775	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1965b0cdebe9017c3397c8641147759	JOSE	12705413746	NULL	12705413746	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1775	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1965b0cdebe9017c3397c8641147759	JOSE	12705413746	NULL	12705413746	51584	ESPARADRAPO MICROPORE	0.0000	0.3800	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1965b0cdebe9017c3397c8641147759	JOSE	12705413746	NULL	12705413746	51584	ESPARADRAPO MICROPORE	0.0000	0.3800	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1965b0cdebe9017c3397c8641147759	JOSE	12705413746	NULL	12705413746	51671	REPARIL (ESCINA + DIETILAMONIO) GL TP GR	0.0000	1.8800	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1965b0cdebe9017c3397c8641147759	JOSE	12705413746	NULL	12705413746	51671	REPARIL (ESCINA + DIETILAMONIO) GL TP GR	0.0000	0.0000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1965b0cdebe9017c3397c8641147759	JOSE	12705413746	NULL	12705413746	00090	SERINGA DESC 20 ML UN	0.0000	0.5375	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	dd6f8d6c53ffe9bfd3aa9590ba500cc8	ILDA	12751932542	NULL	12751932542	04259	DRENO DE SUCCAO	0.0000	0.0960	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	a39fe8b0276da428395df4da4f2b1537	JOSE	12442708440	NULL	12442708440	00128	LUVA DE PROCEDIMENTO UNIDADE UN	0.0000	1.6700	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a39fe8b0276da428395df4da4f2b1537	JOSE	12442708440	NULL	12442708440	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a39fe8b0276da428395df4da4f2b1537	JOSE	12442708440	NULL	12442708440	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a39fe8b0276da428395df4da4f2b1537	JOSE	12442708440	NULL	12442708440	01691	NISTATINA 100.000 UI/ML SU VO ML	0.0000	0.2950	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a39fe8b0276da428395df4da4f2b1537	JOSE	12442708440	NULL	12442708440	01691	NISTATINA 100.000 UI/ML SU VO ML	0.0000	0.2950	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a39fe8b0276da428395df4da4f2b1537	JOSE	12442708440	NULL	12442708440	01691	NISTATINA 100.000 UI/ML SU VO ML	0.0000	0.3000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a39fe8b0276da428395df4da4f2b1537	JOSE	12442708440	NULL	12442708440	20691	HIDROCORTISONA 100 MG PO IM IV FA	0.0000	2.8300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a39fe8b0276da428395df4da4f2b1537	JOSE	12442708440	NULL	12442708440	26981	SORO FISIOLOGICO 0,9% 10 ML SI IV AP	0.0000	0.1400	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a39fe8b0276da428395df4da4f2b1537	JOSE	12442708440	NULL	12442708440	26981	SORO FISIOLOGICO 0,9% 10 ML SI IV AP	0.0000	0.1400	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a39fe8b0276da428395df4da4f2b1537	JOSE	12442708440	NULL	12442708440	26981	SORO FISIOLOGICO 0,9% 10 ML SI IV AP	0.0000	0.1400	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a39fe8b0276da428395df4da4f2b1537	JOSE	12442708440	NULL	12442708440	26981	SORO FISIOLOGICO 0,9% 10 ML SI IV AP	0.0000	0.1400	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a39fe8b0276da428395df4da4f2b1537	JOSE	12442708440	NULL	12442708440	35382	COMPRESSAS DE GASES 7.5 X7,5 (11 FIOS ESTERIL) UN	0.0000	0.1200	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a39fe8b0276da428395df4da4f2b1537	JOSE	12442708440	NULL	12442708440	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1765	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a39fe8b0276da428395df4da4f2b1537	JOSE	12442708440	NULL	12442708440	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1765	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a39fe8b0276da428395df4da4f2b1537	JOSE	12442708440	NULL	12442708440	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1765	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a39fe8b0276da428395df4da4f2b1537	JOSE	12442708440	NULL	12442708440	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1765	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a39fe8b0276da428395df4da4f2b1537	JOSE	12442708440	NULL	12442708440	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1765	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a39fe8b0276da428395df4da4f2b1537	JOSE	12442708440	NULL	12442708440	51241	AGULHA 123X45	0.0000	0.1900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a39fe8b0276da428395df4da4f2b1537	JOSE	12442708440	NULL	12442708440	51241	AGULHA 123X45	0.0000	0.1900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a39fe8b0276da428395df4da4f2b1537	JOSE	12442708440	NULL	12442708440	51241	AGULHA 123X45	0.0000	0.1900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a39fe8b0276da428395df4da4f2b1537	JOSE	12442708440	NULL	12442708440	51241	AGULHA 123X45	0.0000	0.1900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a39fe8b0276da428395df4da4f2b1537	JOSE	12442708440	NULL	12442708440	51659	FENOTEROL 2 MG/ML 10 ML AE IN DS	0.0000	0.2567	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a39fe8b0276da428395df4da4f2b1537	JOSE	12442708440	NULL	12442708440	00090	SERINGA DESC 20 ML UN	0.0000	0.5373	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a39fe8b0276da428395df4da4f2b1537	JOSE	12442708440	NULL	12442708440	00090	SERINGA DESC 20 ML UN	0.0000	0.5373	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a39fe8b0276da428395df4da4f2b1537	JOSE	12442708440	NULL	12442708440	00090	SERINGA DESC 20 ML UN	0.0000	0.5373	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a39fe8b0276da428395df4da4f2b1537	JOSE	12442708440	NULL	12442708440	00090	SERINGA DESC 20 ML UN	0.0000	0.5373	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	61e4786d45edfdbf19b77fb2c6ce6b9c	REINALDO	12754482747	NULL	12754482747	00172	SORO FISIOLOGICO 0,9% 500 ML SI IV BS	0.0000	4.7300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	61e4786d45edfdbf19b77fb2c6ce6b9c	REINALDO	12754482747	NULL	12754482747	00172	SORO FISIOLOGICO 0,9% 500 ML SI IV BS	0.0000	4.7300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	61e4786d45edfdbf19b77fb2c6ce6b9c	REINALDO	12754482747	NULL	12754482747	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	61e4786d45edfdbf19b77fb2c6ce6b9c	REINALDO	12754482747	NULL	12754482747	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	61e4786d45edfdbf19b77fb2c6ce6b9c	REINALDO	12754482747	NULL	12754482747	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.0000	0.6900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	61e4786d45edfdbf19b77fb2c6ce6b9c	REINALDO	12754482747	NULL	12754482747	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.0000	0.6900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	61e4786d45edfdbf19b77fb2c6ce6b9c	REINALDO	12754482747	NULL	12754482747	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.0000	0.4000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	61e4786d45edfdbf19b77fb2c6ce6b9c	REINALDO	12754482747	NULL	12754482747	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.0000	0.4000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	61e4786d45edfdbf19b77fb2c6ce6b9c	REINALDO	12754482747	NULL	12754482747	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	61e4786d45edfdbf19b77fb2c6ce6b9c	REINALDO	12754482747	NULL	12754482747	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	102001	DIARIA DE APARTAMENTO	0.0000	288.8880	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	102001	DIARIA DE APARTAMENTO	0.0000	288.8880	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4072	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4072	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4072	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4072	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4072	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	51649	ALCOOL ETILICO 70 % ST TP ML	0.0000	0.0600	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	00090	SERINGA DESC 20 ML UN	0.0000	0.5371	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	00090	SERINGA DESC 20 ML UN	0.0000	0.5371	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	00090	SERINGA DESC 20 ML UN	0.0000	0.5371	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	00090	SERINGA DESC 20 ML UN	0.0000	0.5371	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	00090	SERINGA DESC 20 ML UN	0.0000	0.5371	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	00090	SERINGA DESC 20 ML UN	0.0000	0.5371	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	00090	SERINGA DESC 20 ML UN	0.0000	0.5371	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	00090	SERINGA DESC 20 ML UN	0.0000	0.5371	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	00090	SERINGA DESC 20 ML UN	0.0000	0.5371	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	00090	SERINGA DESC 20 ML UN	0.0000	0.5371	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	00090	SERINGA DESC 20 ML UN	0.0000	0.5371	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	00090	SERINGA DESC 20 ML UN	0.0000	0.5371	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	00091	SERINGA DESC 01 ML (INSULINA) UN	0.0000	0.3100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	081fdadb830fb547e83c43fabdb88372	ELZA	12377335349	NULL	12377335349	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	081fdadb830fb547e83c43fabdb88372	ELZA	12377335349	NULL	12377335349	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	081fdadb830fb547e83c43fabdb88372	ELZA	12377335349	NULL	12377335349	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	081fdadb830fb547e83c43fabdb88372	ELZA	12377335349	NULL	12377335349	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	081fdadb830fb547e83c43fabdb88372	ELZA	12377335349	NULL	12377335349	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	081fdadb830fb547e83c43fabdb88372	ELZA	12377335349	NULL	12377335349	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	081fdadb830fb547e83c43fabdb88372	ELZA	12377335349	NULL	12377335349	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	081fdadb830fb547e83c43fabdb88372	ELZA	12377335349	NULL	12377335349	01611	CLORETO DE POTASSIO 600 MG CA VO UN	0.0000	0.4900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	081fdadb830fb547e83c43fabdb88372	ELZA	12377335349	NULL	12377335349	01611	CLORETO DE POTASSIO 600 MG CA VO UN	0.0000	0.4900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	081fdadb830fb547e83c43fabdb88372	ELZA	12377335349	NULL	12377335349	02246	HIDROCORTISONA 100 MG PO IM IV FA	0.0000	5.6700	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	081fdadb830fb547e83c43fabdb88372	ELZA	12377335349	NULL	12377335349	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1800	NULL	PAGO CONFORME RELATORIO DE AUDITORIA EXTERNA ― CONTA INICIAL	1717
Glosa Min	2018-10-03 00:00:00.000000	1084117	081fdadb830fb547e83c43fabdb88372	ELZA	12377335349	NULL	12377335349	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1800	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	35382	COMPRESSAS DE GASES 7.5 X7,5 (11 FIOS ESTERIL) UN	0.0000	0.6000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	51379	SERINGA DESC 05 ML UN	0.0000	0.1900	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	51379	SERINGA DESC 05 ML UN	0.0000	0.1900	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	51379	SERINGA DESC 05 ML UN	0.0000	0.1900	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	51379	SERINGA DESC 05 ML UN	0.0000	0.1900	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	51379	SERINGA DESC 05 ML UN	0.0000	0.1900	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	345c226bfea274af1372d41b0305a6c8	ALTINO	12720257940	NULL	12720257940	00493	BROMOPRIDA 5 MG/ML 2 ML SI IM IV AP	0.0000	2.7300	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	345c226bfea274af1372d41b0305a6c8	ALTINO	12720257940	NULL	12720257940	00090	SERINGA DESC 20 ML UN	0.0000	0.5367	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	4668d2494ed6c4b2d18be299efcb26a2	JOAO	12469689344	NULL	12469689344	00123	LUVA CIRURGICA UN	NULL	0.0000	NULL	OPME INVALIDO	2201
Glosa Min	2018-10-03 00:00:00.000000	1084117	dd486d36a88cfef0b44fe652638a0164	DELFINA	12660326244	NULL	12660326244	00128	LUVA DE PROCEDIMENTO UNIDADE UN	0.0000	1.0000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	dd486d36a88cfef0b44fe652638a0164	DELFINA	12660326244	NULL	12660326244	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR APRESENTADO A MAIOR	1705
Glosa Min	2018-10-03 00:00:00.000000	1084117	dd486d36a88cfef0b44fe652638a0164	DELFINA	12660326244	NULL	12660326244	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	dd486d36a88cfef0b44fe652638a0164	DELFINA	12660326244	NULL	12660326244	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	dd486d36a88cfef0b44fe652638a0164	DELFINA	12660326244	NULL	12660326244	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	dd486d36a88cfef0b44fe652638a0164	DELFINA	12660326244	NULL	12660326244	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	dd486d36a88cfef0b44fe652638a0164	DELFINA	12660326244	NULL	12660326244	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	dd486d36a88cfef0b44fe652638a0164	DELFINA	12660326244	NULL	12660326244	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	dd486d36a88cfef0b44fe652638a0164	DELFINA	12660326244	NULL	12660326244	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	dd486d36a88cfef0b44fe652638a0164	DELFINA	12660326244	NULL	12660326244	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	dd486d36a88cfef0b44fe652638a0164	DELFINA	12660326244	NULL	12660326244	00090	SERINGA DESC 20 ML UN	0.0000	0.5400	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	dd486d36a88cfef0b44fe652638a0164	DELFINA	12660326244	NULL	12660326244	00090	SERINGA DESC 20 ML UN	0.0000	0.5400	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	dd486d36a88cfef0b44fe652638a0164	DELFINA	12660326244	NULL	12660326244	00090	SERINGA DESC 20 ML UN	0.0000	0.5400	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	dd486d36a88cfef0b44fe652638a0164	DELFINA	12660326244	NULL	12660326244	00090	SERINGA DESC 20 ML UN	0.0000	0.5400	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	dd486d36a88cfef0b44fe652638a0164	DELFINA	12660326244	NULL	12660326244	00090	SERINGA DESC 20 ML UN	0.0000	0.5400	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	01652	TRAMADOL 50 MG CP VO UN	0.0000	1.9300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.0000	0.6900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.0000	0.6900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.0000	0.6900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.0000	0.6900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.0000	0.6900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.0000	0.6900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	35382	COMPRESSAS DE GASES 7.5 X7,5 (11 FIOS ESTERIL) UN	0.0000	0.3000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	35382	COMPRESSAS DE GASES 7.5 X7,5 (11 FIOS ESTERIL) UN	0.0000	0.3000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1800	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1800	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1800	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1800	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	51588	ESPARADRAPO MICROPORE 50 X 10 CM CM	0.0000	0.7700	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	51589	ESPARADRAPO 10 X 4.5 CM CM	0.0000	0.4000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3fb5c891f31bb9efcb05395066127c52	ALAIDE	12636273441	NULL	12636273441	00487	RANITIDINA 25 MG/ML 2 ML SI IM IV AP	0.0000	0.0000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	610c198ec4c064687cf0524f147d3aed	ROBERTO	12748814743	NULL	12748814743	16322	BENZILPENICILINA POTASSICA CRIST. 5.000.000	8.0700	8.0685	0.0017	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	6ccea6ac8c216c032723aee73a9f81c9	PRISCILA	12662249242	NULL	12662249242	32719	CEFAZOLINA 1 GR + DIL. 10 ML FA	8.1300	8.1275	0.0025	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	6ccea6ac8c216c032723aee73a9f81c9	PRISCILA	12662249242	NULL	12662249242	32719	CEFAZOLINA 1 GR + DIL. 10 ML FA	8.1300	8.1275	0.0025	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	6ccea6ac8c216c032723aee73a9f81c9	PRISCILA	12662249242	NULL	12662249242	32719	CEFAZOLINA 1 GR + DIL. 10 ML FA	16.2600	16.2550	0.0050	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	51378	SERINGA DESC 03 ML UN	0.1500	0.0600	0.0900	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	51378	SERINGA DESC 03 ML UN	0.1500	0.0600	0.0900	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00919	ALGODAO HIDROFILO BOLINHA UN	0.2600	0.1100	0.1500	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	03280	CLOREXIDINA 2 % ST TP ML	0.2700	0.1100	0.1600	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	03280	CLOREXIDINA 2 % ST TP ML	0.2700	0.1100	0.1600	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00127	LUVA DE PROCEDIMENTO UNIDADE UN	0.3300	0.1300	0.2000	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00127	LUVA DE PROCEDIMENTO UNIDADE UN	0.3300	0.1300	0.2000	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00127	LUVA DE PROCEDIMENTO UNIDADE UN	0.3300	0.1300	0.2000	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00127	LUVA DE PROCEDIMENTO UNIDADE UN	0.3300	0.1300	0.2000	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00127	LUVA DE PROCEDIMENTO UNIDADE UN	0.3300	0.1300	0.2000	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.4000	0.1600	0.2400	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.4000	0.1600	0.2400	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.4000	0.1600	0.2400	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.4000	0.1600	0.2400	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.4000	0.1600	0.2400	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	51589	ESPARADRAPO 10 X 4.5 CM CM	0.4000	0.1600	0.2400	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	54687	IODOPOVIDONA SD TP ML	0.4000	0.1600	0.2400	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00020010	Visita Hospitalar (Paciente Internado)	43.8000	17.1000	26.7000	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	07802	PIPERACILINA 4 G + TAZOBACTAM 500 MG PO IV FA	83.4500	32.5900	50.8600	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	07802	PIPERACILINA 4 G + TAZOBACTAM 500 MG PO IV FA	83.4500	32.5900	50.8600	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	02734	TARGOCID (TEICOPLANINA) 400 MG 3 ML PO IM IV FA	362.7200	141.6500	221.0700	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	01081197	5125859e8d2860b83822c41756a9b5bf	ESMERALDA	12734516820	NULL	12734516820...	32040040	RX Articulação Coxo - Femural	0.0000	23.1250	NULL	EXAME SEM REGISTRO DE EXECUCAO	2703
Glosa Min	2018-10-03 00:00:00.000000	01081197	5125859e8d2860b83822c41756a9b5bf	ESMERALDA	12734516820	NULL	12734516820...	32040059	RX Coxa	0.0000	24.0850	NULL	EXAME SEM REGISTRO DE EXECUCAO	2703
Glosa Min	2018-10-03 00:00:00.000000	01081197	e0b1f77dc9cff210f2fbead99c7ba4d4	MARCIO	12790052920	NULL	12790052920	00090	SERINGA DESC 20 ML UN	NULL	0.0000	NULL	OPME INVALIDO	2201
Glosa Min	2018-10-03 00:00:00.000000	01081197	3af14fcc4f764a77ed38b3d2e81bcc76	JOAO	12687535922	NULL	12687535922	00220	ELETRODO DESCARTAVEL (UTI) UN	NULL	0.0000	NULL	OPME INVALIDO	2201
Glosa Min	2018-10-03 00:00:00.000000	1084117	16b1e9f62f247f02ad5cac910ee15b4e	BERCHOLINA	12631612848	NULL	12631612848	00171	SORO FISIOLOGICO 0,9% 250 ML SI IV BS	3.9400	3.7600	0.1800	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	16b1e9f62f247f02ad5cac910ee15b4e	BERCHOLINA	12631612848	NULL	12631612848	04073	TRAMADOL 50 MG 1 ML SI IM IV AP	4.1900	4.0000	0.1900	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	16b1e9f62f247f02ad5cac910ee15b4e	BERCHOLINA	12631612848	NULL	12631612848	04073	TRAMADOL 50 MG 1 ML SI IM IV AP	4.1900	3.9900	0.2000	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	16b1e9f62f247f02ad5cac910ee15b4e	BERCHOLINA	12631612848	NULL	12631612848	22421	PIPERACILINA 2 G + TAZOBACTAM 250 MG 30 ML PO IV	55.3400	52.7400	2.6000	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	16b1e9f62f247f02ad5cac910ee15b4e	BERCHOLINA	12631612848	NULL	12631612848	20080	LINEZOLIDA 2 MG/ML 300 ML SI IV BS	174.9800	166.7800	8.2000	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	16b1e9f62f247f02ad5cac910ee15b4e	BERCHOLINA	12631612848	NULL	12631612848	20080	LINEZOLIDA 2 MG/ML 300 ML SI IV BS	174.9800	166.7800	8.2000	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	16b1e9f62f247f02ad5cac910ee15b4e	BERCHOLINA	12631612848	NULL	12631612848	20080	LINEZOLIDA 2 MG/ML 300 ML SI IV BS	174.9800	166.7800	8.2000	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	01081195	dc9eaa384ae79bd374f6eb26ed4e6234	MARCELO	12751149116	NULL	12751149116	00010014	CONSULTA EM CONSULTORIO MEDICO	0.0000	0.0000	50.0000	GUIA DE CONSULTA NAO EXECUTADA	0622
Glosa Min	2018-10-03 00:00:00.000000	01081195	1f5f0c7f56ddf383ee0b633380db5501	CLAUDIA	12811247910	NULL	12811247910	00010014	CONSULTA EM CONSULTORIO MEDICO	0.0000	0.0000	50.0000	GUIA DE CONSULTA NAO EXECUTADA	0622
Glosa Min	2018-10-03 00:00:00.000000	01081195	8e66184ab6a0f3f9076a2217f2e6fe1d	AGUINALDO	12761336014	NULL	12761336014	00010014	CONSULTA EM CONSULTORIO MEDICO	0.0000	0.0000	50.0000	GUIA DE CONSULTA NAO EXECUTADA	0622
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12579183644	NULL	12579183644	00817	ALGODAO HIDROFILO BOLINHA UN	0.5100	0.2600	0.2500	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12579183644	NULL	12579183644	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.3500	0.0000	0.3500	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12579183644	NULL	12579183644	00817	ALGODAO HIDROFILO BOLINHA UN	0.5100	0.2600	0.2500	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12579183644	NULL	12579183644	37761	ALCOOL ETILICO 70 % ST TP ML	0.0600	0.0300	0.0300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	d17b3c5ae418d82694895a326dee545a	ODILIA	12670516743	NULL	12670516743	33219	LUVA DE PROCEDIMENTO UNIDADE UN	1.0000	0.6700	0.3300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	20cbe2e07b1dcd2b6af609a50df7ae80	LUCELENA	12690767849	NULL	12690767849	00817	ALGODAO HIDROFILO BOLINHA UN	0.2600	0.1300	0.1300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	20cbe2e07b1dcd2b6af609a50df7ae80	LUCELENA	12690767849	NULL	12690767849	00817	ALGODAO HIDROFILO BOLINHA UN	0.5100	0.1300	0.3800	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	20cbe2e07b1dcd2b6af609a50df7ae80	LUCELENA	12690767849	NULL	12690767849	00817	ALGODAO HIDROFILO BOLINHA UN	0.5100	0.2600	0.2500	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	02739	BOLSA COLETORA (SISTEMA FECHADO) UN	5.9300	0.0000	5.9300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	19763	SONDA FOLEY 2 VIAS Nş 16 UN	3.8200	0.0000	3.8200	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	08460	EQUIPO P/ SOLUÇOES FOTOSSENSIVEIS UN	16.4000	0.0000	16.4000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	37761	ALCOOL ETILICO 70 % ST TP ML	0.0300	0.0200	0.0100	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	08648	ESPARADRAPO 10 X 4.5 CM CM	0.4000	0.2000	0.2000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00426	AGUA BIDESTILADA 10 ML SI IV IM AP	0.8100	0.4000	0.4100	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	08648	ESPARADRAPO 10 X 4.5 CM CM	0.4000	0.2000	0.2000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	11193	CLOREXIDINA 2 % ST TP ML	1.6000	0.5300	1.0700	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	752c651cb4fd049e19c685f87fbe8bdc	EDUARDO	12765990646	NULL	12765990646	08435	EQUIPO P/ BOMBA DE INFUSAO ENTERAL / PARENT	40.5600	20.2800	20.2800	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	752c651cb4fd049e19c685f87fbe8bdc	EDUARDO	12765990646	NULL	12765990646	00817	ALGODAO HIDROFILO BOLINHA UN	0.5100	0.1300	0.3800	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3d5131ef222e15b77c298e3372afc496	MARIA	12665213047	NULL	12665213047	58750	AGULHA P/ PUNÇAO PERCUTANEA UN	82.0000	0.0000	82.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	33219	LUVA DE PROCEDIMENTO UNIDADE UN	1.0000	0.6700	0.3300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	05975	COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER	0.0300	0.0000	0.0300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	37761	ALCOOL ETILICO 70 % ST TP ML	0.0300	0.0200	0.0100	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00817	ALGODAO HIDROFILO BOLINHA UN	0.2600	0.1300	0.1300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	33219	LUVA DE PROCEDIMENTO UNIDADE UN	1.0000	0.6700	0.3300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	345c226bfea274af1372d41b0305a6c8	ALTINO	12720257940	NULL	12720257940	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.1000	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	345c226bfea274af1372d41b0305a6c8	ALTINO	12720257940	NULL	12720257940	13404	OMEPRAZOL 40 MG + DIL. 10 ML PO IV FA	19.5800	19.5750	0.0050	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	345c226bfea274af1372d41b0305a6c8	ALTINO	12720257940	NULL	12720257940	13404	OMEPRAZOL 40 MG + DIL. 10 ML PO IV FA	19.5800	19.5750	0.0050	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	31d18d6607d9e742c53e748d6a55d740	CARLOS	12557779343	NULL	12557779343	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1760	0.0040	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	31d18d6607d9e742c53e748d6a55d740	CARLOS	12557779343	NULL	12557779343	07269	DIPIRONA 500 MG/ML 2 ML SI IV IM AP	0.6900	0.6860	0.0040	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	0405a686318e3fc262f105ed4be24d95	CARMELITA	12687161644	NULL	12687161644	07269	DIPIRONA 500 MG/ML 2 ML SI IV IM AP	0.6900	0.6873	0.0027	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	ea6abb4182a48f0934f3e9eb5affa056	DILVA	12697455440	NULL	12697455440	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1750	0.0050	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	500e4b8f04552b423f9db8f81073659f	FIDELIS	12763450340	NULL	12763450340	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	6.8200	6.8100	0.0000	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	500e4b8f04552b423f9db8f81073659f	FIDELIS	12763450340	NULL	12763450340	30511	CEFALOTINA 1 G FA + DIL. 10 ML FA	4.6600	4.6500	0.0000	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	27600	ONDANSETRONA 2 MG/ML 4 ML SI IM IV AP	13.5300	0.0000	13.5300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	27600	ONDANSETRONA 2 MG/ML 4 ML SI IM IV AP	13.5300	0.0000	13.5300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	27600	ONDANSETRONA 2 MG/ML 4 ML SI IM IV AP	13.5300	0.0000	13.5300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	27600	ONDANSETRONA 2 MG/ML 4 ML SI IM IV AP	13.5300	0.0000	13.5300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	08664	ESPARADRAPO MICROPORE 50 X 10 CM CM	0.2600	0.2562	0.0038	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	52353	ABAIXADOR DE LINGUA UN	0.0500	0.0000	0.0500	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	17310	IODOPOVIDONA ALCOOLICA SL TP ML	0.6000	0.0000	0.6000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	31d18d6607d9e742c53e748d6a55d740	CARLOS	12557779343	NULL	12557779343	08664	ESPARADRAPO MICROPORE 50 X 10 CM CM	0.7700	0.5100	0.2600	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	31d18d6607d9e742c53e748d6a55d740	CARLOS	12557779343	NULL	12557779343	11193	CLOREXIDINA 2 % ST TP ML	2.6600	1.8600	0.8000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	31d18d6607d9e742c53e748d6a55d740	CARLOS	12557779343	NULL	12557779343	08664	ESPARADRAPO MICROPORE 50 X 10 CM CM	2.5600	0.5100	2.0500	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	32891	EQUIPO POLIFIX 2ş VIAS UN	5.1000	2.5500	2.5500	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	21822	TRAMADOL 50 MG 1 ML SI IM IV AP	4.1900	0.0000	4.1900	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	32891	EQUIPO POLIFIX 2ş VIAS UN	5.1000	0.0000	5.1000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	32891	EQUIPO POLIFIX 2ş VIAS UN	2.5500	0.0000	2.5500	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	00817	ALGODAO HIDROFILO BOLINHA UN	0.2600	0.1300	0.1300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	f15dde67c6bce10519b3c6376759939c	JOAO	12625226846	NULL	12625226846	08648	ESPARADRAPO 10 X 4.5 CM CM	2.0000	1.0200	0.9800	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	9ffbbf7340bbd65e9e3baa9406d027f3	MARCO	12261811645	NULL	12261811645	33219	LUVA DE PROCEDIMENTO UNIDADE UN	1.0000	0.6700	0.3300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	9ffbbf7340bbd65e9e3baa9406d027f3	MARCO	12261811645	NULL	12261811645	00817	ALGODAO HIDROFILO BOLINHA UN	0.2600	0.1300	0.1300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	9ffbbf7340bbd65e9e3baa9406d027f3	MARCO	12261811645	NULL	12261811645	37761	ALCOOL ETILICO 70 % ST TP ML	0.0300	0.0200	0.0100	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	9ffbbf7340bbd65e9e3baa9406d027f3	MARCO	12261811645	NULL	12261811645	33219	LUVA DE PROCEDIMENTO UNIDADE UN	1.0000	0.6700	0.3300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	9ffbbf7340bbd65e9e3baa9406d027f3	MARCO	12261811645	NULL	12261811645	37761	ALCOOL ETILICO 70 % ST TP ML	0.0300	0.0200	0.0100	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	9ffbbf7340bbd65e9e3baa9406d027f3	MARCO	12261811645	NULL	12261811645	00817	ALGODAO HIDROFILO BOLINHA UN	0.2600	0.1300	0.1300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	9ffbbf7340bbd65e9e3baa9406d027f3	MARCO	12261811645	NULL	12261811645	37761	ALCOOL ETILICO 70 % ST TP ML	0.0600	0.0200	0.0400	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	9ffbbf7340bbd65e9e3baa9406d027f3	MARCO	12261811645	NULL	12261811645	37761	ALCOOL ETILICO 70 % ST TP ML	0.0600	0.0200	0.0400	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	19160	SERINGA DESC 20 ML UN	0.5400	0.0000	0.5400	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	00817	ALGODAO HIDROFILO BOLINHA UN	0.5100	0.2600	0.2500	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	00817	ALGODAO HIDROFILO BOLINHA UN	0.5100	0.2600	0.2500	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	00817	ALGODAO HIDROFILO BOLINHA UN	0.5100	0.2600	0.2500	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	37680	FIO MONONYLON 0 C/ AGULHA 2,0 3/8 14505T U	14.9100	7.4600	7.4500	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	00817	ALGODAO HIDROFILO BOLINHA UN	0.5100	0.2600	0.2500	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	cd2840524be5a3f1d0939f241e24f32b	MARIA	12705908340	NULL	12705908340	00817	ALGODAO HIDROFILO BOLINHA UN	0.2600	0.1300	0.1300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	cd2840524be5a3f1d0939f241e24f32b	MARIA	12705908340	NULL	12705908340	53660	EQUIPO MACRO-GOTAS FLEXIVEL C/ INJETOR LATE	1.5900	0.0000	1.5900	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	cd2840524be5a3f1d0939f241e24f32b	MARIA	12705908340	NULL	12705908340	37761	ALCOOL ETILICO 70 % ST TP ML	0.0300	0.0200	0.0100	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	cd2840524be5a3f1d0939f241e24f32b	MARIA	12705908340	NULL	12705908340	52582	CATETER OXIGENIO TIPO OCULOS UN	1.0000	0.0000	1.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12603877940	NULL	12603877940	00817	ALGODAO HIDROFILO BOLINHA UN	0.2600	0.1300	0.1300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12603877940	NULL	12603877940	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.3100	0.0000	0.3100	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12603877940	NULL	12603877940	19143	SERINGA DESC 05 ML UN	0.5800	0.0000	0.5800	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12603877940	NULL	12603877940	33219	LUVA DE PROCEDIMENTO UNIDADE UN	1.3300	0.6700	0.6600	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12603877940	NULL	12603877940	00817	ALGODAO HIDROFILO BOLINHA UN	0.2600	0.1300	0.1300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12603877940	NULL	12603877940	00817	ALGODAO HIDROFILO BOLINHA UN	0.2600	0.1300	0.1300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12603877940	NULL	12603877940	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.4100	0.1000	0.3100	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12603877940	NULL	12603877940	11193	CLOREXIDINA 2 % ST TP ML	2.1300	1.3300	0.8000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12603877940	NULL	12603877940	13757	IODOPOVIDONA SD TP ML	0.4000	0.0000	0.4000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12603877940	NULL	12603877940	33219	LUVA DE PROCEDIMENTO UNIDADE UN	2.3300	0.6700	1.6600	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12603877940	NULL	12603877940	33219	LUVA DE PROCEDIMENTO UNIDADE UN	2.3300	0.6700	1.6600	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12603877940	NULL	12603877940	00817	ALGODAO HIDROFILO BOLINHA UN	0.2600	0.1300	0.1300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12603877940	NULL	12603877940	22748	LIDOCAINA 2% GE TP OU GR	2.5900	1.3000	1.2900	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12603877940	NULL	12603877940	07269	DIPIRONA 500 MG/ML 2 ML SI IV IM AP	2.0600	1.3700	0.6900	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	33219	LUVA DE PROCEDIMENTO UNIDADE UN	1.0000	0.6700	0.3300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	02461	FENOTEROL 2 MG/ML 10 ML AE IN DS	2.1300	0.0000	2.1300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	33219	LUVA DE PROCEDIMENTO UNIDADE UN	1.0000	0.6700	0.3300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	02461	FENOTEROL 2 MG/ML 10 ML AE IN DS	2.5500	0.0000	2.5500	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	818a6f2e549cc6a60aa20f9d0595eec9	ANTONIO	12565134343	NULL	12565134343	19160	SERINGA DESC 20 ML UN	0.5400	0.5371	0.0029	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	a050ed50115d2a6dd0b15b99b39063da	ARI	12676101147	NULL	12676101147	13404	OMEPRAZOL 40 MG + DIL. 10 ML PO IV FA	19.5800	19.5750	0.0050	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	edffb7fef608512400078fdf75991573	CARLA	12728631049	NULL	12728631049	32719	CEFAZOLINA 1 GR + DIL. 10 ML FA	16.2600	16.2500	0.0000	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	edffb7fef608512400078fdf75991573	CARLA	12728631049	NULL	12728631049	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1760	0.0040	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	9be01c766c547e19f866de2a24c5d27c	DORALICE	12676142945	NULL	12676142945	33219	LUVA DE PROCEDIMENTO UNIDADE UN	1.6700	1.6600	0.0000	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	39df67956a358bf1eab89803158d25dd	HELENA	12655863342	NULL	12655863342	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1750	0.0050	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	39df67956a358bf1eab89803158d25dd	HELENA	12655863342	NULL	12655863342	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1750	0.0050	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	39df67956a358bf1eab89803158d25dd	HELENA	12655863342	NULL	12655863342	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1750	0.0050	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	cb57fc8e673b7c8bc339e1fe25d70cd5	HELIO	12661165148	NULL	12661165148	07269	DIPIRONA 500 MG/ML 2 ML SI IV IM AP	0.6900	0.6867	0.0033	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	9d06dbe3a8516628c3a045963dfb9c42	INAN	12623574546	NULL	12623574546	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1758	0.0042	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	9d06dbe3a8516628c3a045963dfb9c42	INAN	12623574546	NULL	12623574546	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1757	0.0043	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	4668d2494ed6c4b2d18be299efcb26a2	JOAO	12469689344	NULL	12469689344	22896	CEFUROXIMA 750 MG + DIL. 6 ML PO IM IV FA	78.3800	78.3700	0.0000	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	4668d2494ed6c4b2d18be299efcb26a2	JOAO	12469689344	NULL	12469689344	05975	COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER	0.0300	0.0000	0.0300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	4668d2494ed6c4b2d18be299efcb26a2	JOAO	12469689344	NULL	12469689344	05975	COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER	0.0300	0.0000	0.0300	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	4668d2494ed6c4b2d18be299efcb26a2	JOAO	12469689344	NULL	12469689344	17817	PROLOPA (LEVODOPA 200 MG + BENSERAZIDA 50 M	2.1200	2.1150	0.0050	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	a39fe8b0276da428395df4da4f2b1537	JOSE	12442708440	NULL	12442708440	02461	FENOTEROL 2 MG/ML 10 ML AE IN DS	0.2600	0.2567	0.0033	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	01081195	b79a14169b7b425d375290c6efbc8814	JOSE	12742536611	NULL	12742536611	00010014	CONSULTA EM CONSULTORIO MEDICO	0.0000	35.0000	NULL	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	01081195	754284f4c7edf7cb27a629b4949481b5	MARIA	12743093713	NULL	12743093713	00010014	CONSULTA EM CONSULTORIO MEDICO	0.0000	35.0000	NULL	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	25030019	DISTURBIOS CIRCULATORIOS ARTERIO VE	0.0000	160.4800	NULL	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	de1a8276d878171456d7fc8f6dcd2457	ABEL	12764206443	NULL	12764206443	07269	DIPIRONA 500 MG/ML 2 ML SI IV IM AP	0.6900	0.6860	0.0040	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	de1a8276d878171456d7fc8f6dcd2457	ABEL	12764206443	NULL	12764206443	07269	DIPIRONA 500 MG/ML 2 ML SI IV IM AP	0.6900	0.6860	0.0040	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	eecb3d883747b059c3fe231c34567476	AFFRIDES	12693180144	NULL	12693180144	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1770	0.0030	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	eecb3d883747b059c3fe231c34567476	AFFRIDES	12693180144	NULL	12693180144	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1770	0.0030	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	eecb3d883747b059c3fe231c34567476	AFFRIDES	12693180144	NULL	12693180144	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1770	0.0030	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	eecb3d883747b059c3fe231c34567476	AFFRIDES	12693180144	NULL	12693180144	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1770	0.0030	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	eecb3d883747b059c3fe231c34567476	AFFRIDES	12693180144	NULL	12693180144	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1770	0.0030	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	eecb3d883747b059c3fe231c34567476	AFFRIDES	12693180144	NULL	12693180144	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1770	0.0030	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	eecb3d883747b059c3fe231c34567476	AFFRIDES	12693180144	NULL	12693180144	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1770	0.0030	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	eecb3d883747b059c3fe231c34567476	AFFRIDES	12693180144	NULL	12693180144	00426	AGUA BIDESTILADA 10 ML SI IV IM AP	0.8100	0.8072	0.0028	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	eecb3d883747b059c3fe231c34567476	AFFRIDES	12693180144	NULL	12693180144	00426	AGUA BIDESTILADA 10 ML SI IV IM AP	0.8100	0.8072	0.0028	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	eecb3d883747b059c3fe231c34567476	AFFRIDES	12693180144	NULL	12693180144	00426	AGUA BIDESTILADA 10 ML SI IV IM AP	0.8100	0.8072	0.0028	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	eecb3d883747b059c3fe231c34567476	AFFRIDES	12693180144	NULL	12693180144	00426	AGUA BIDESTILADA 10 ML SI IV IM AP	0.8100	0.8072	0.0028	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	eecb3d883747b059c3fe231c34567476	AFFRIDES	12693180144	NULL	12693180144	00426	AGUA BIDESTILADA 10 ML SI IV IM AP	0.8100	0.8072	0.0028	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	eecb3d883747b059c3fe231c34567476	AFFRIDES	12693180144	NULL	12693180144	00426	AGUA BIDESTILADA 10 ML SI IV IM AP	0.8100	0.8072	0.0028	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	eecb3d883747b059c3fe231c34567476	AFFRIDES	12693180144	NULL	12693180144	00426	AGUA BIDESTILADA 10 ML SI IV IM AP	0.8100	0.8072	0.0028	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	eecb3d883747b059c3fe231c34567476	AFFRIDES	12693180144	NULL	12693180144	09733	ACETILCISTEINA 600MG PO VO SA	3.5000	3.4955	0.0045	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	eecb3d883747b059c3fe231c34567476	AFFRIDES	12693180144	NULL	12693180144	09733	ACETILCISTEINA 600MG PO VO SA	3.5000	3.4955	0.0045	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	eecb3d883747b059c3fe231c34567476	AFFRIDES	12693180144	NULL	12693180144	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4083	0.0017	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	08664	ESPARADRAPO MICROPORE 50 X 10 CM CM	0.2600	0.2561	0.0039	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	08664	ESPARADRAPO MICROPORE 50 X 10 CM CM	0.7700	0.7682	0.0018	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	08664	ESPARADRAPO MICROPORE 50 X 10 CM CM	0.7700	0.7682	0.0018	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	20672	SORO RINGER SIMPLES 500 ML SI IV BS	5.9400	5.9367	0.0033	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	42358	FUROSEMIDA 10 MG/ML 2 ML SI IM IV AP	0.6000	0.5986	0.0014	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4066	0.0034	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4078	0.0022	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4078	0.0022	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4078	0.0022	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4078	0.0022	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	33227	LUVA CIRURGICA PAR UN	1.4500	1.4476	0.0024	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	33227	LUVA CIRURGICA PAR UN	1.4500	1.4476	0.0024	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	33227	LUVA CIRURGICA PAR UN	1.4500	1.4476	0.0024	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	33227	LUVA CIRURGICA PAR UN	1.4500	1.4476	0.0024	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.1038	-0.0038	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.1038	-0.0038	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.1038	-0.0038	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	b288bbcfb9aecab51bcb0dba62ca0059	IVONETE	12743730847	NULL	12743730847	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4067	0.0033	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	b288bbcfb9aecab51bcb0dba62ca0059	IVONETE	12743730847	NULL	12743730847	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4067	0.0033	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	b288bbcfb9aecab51bcb0dba62ca0059	IVONETE	12743730847	NULL	12743730847	19160	SERINGA DESC 20 ML UN	0.5400	0.5367	0.0033	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	b288bbcfb9aecab51bcb0dba62ca0059	IVONETE	12743730847	NULL	12743730847	19160	SERINGA DESC 20 ML UN	0.5400	0.5367	0.0033	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	b288bbcfb9aecab51bcb0dba62ca0059	IVONETE	12743730847	NULL	12743730847	19160	SERINGA DESC 20 ML UN	0.5400	0.5367	0.0033	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	b288bbcfb9aecab51bcb0dba62ca0059	IVONETE	12743730847	NULL	12743730847	19160	SERINGA DESC 20 ML UN	0.5400	0.5367	0.0033	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12558131243	NULL	12558131243	05975	COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER	0.9000	0.3800	0.5200	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1800	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1700	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	08664	ESPARADRAPO MICROPORE 50 X 10 CM CM	0.7700	0.0000	0.7700	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4084	0.0016	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4084	0.0016	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4084	0.0016	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4084	0.0016	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4084	0.0016	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4084	0.0016	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4084	0.0016	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4084	0.0016	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4084	0.0016	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4084	0.0016	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.1036	-0.0036	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1965b0cdebe9017c3397c8641147759	JOSE	12705413746	NULL	12705413746	18457	REPARIL (ESCINA + DIETILAMONIO) GL TP GR	3.7500	0.0000	3.7500	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1965b0cdebe9017c3397c8641147759	JOSE	12705413746	NULL	12705413746	18457	REPARIL (ESCINA + DIETILAMONIO) GL TP GR	3.7500	0.0000	3.7500	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	20cbe2e07b1dcd2b6af609a50df7ae80	LUCELENA	12690767849	NULL	12690767849	19160	SERINGA DESC 20 ML UN	0.5400	0.5384	0.0016	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	05975	COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER	0.3000	0.0000	0.3000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	32204	CLORETO DE SODIO 0,9% 10 ML SI IV AP	0.4800	0.4800	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	00426	AGUA BIDESTILADA 10 ML SI IV IM AP	0.8100	0.8067	0.0033	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	00426	AGUA BIDESTILADA 10 ML SI IV IM AP	0.8100	0.8067	0.0033	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	00426	AGUA BIDESTILADA 10 ML SI IV IM AP	0.8100	0.8067	0.0033	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	00426	AGUA BIDESTILADA 10 ML SI IV IM AP	0.8100	0.8067	0.0033	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	00426	AGUA BIDESTILADA 10 ML SI IV IM AP	0.8100	0.8067	0.0033	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	32204	CLORETO DE SODIO 0,9% 10 ML SI IV AP	0.4800	0.0000	0.4800	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	32204	CLORETO DE SODIO 0,9% 10 ML SI IV AP	0.4800	0.0000	0.4800	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	32204	CLORETO DE SODIO 0,9% 10 ML SI IV AP	0.9600	0.0000	0.9600	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	33219	LUVA DE PROCEDIMENTO UNIDADE UN	0.3300	0.0000	0.3300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	53660	EQUIPO MACRO-GOTAS FLEXIVEL C/ INJETOR LATE	1.5900	0.0000	1.5900	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	32204	CLORETO DE SODIO 0,9% 10 ML SI IV AP	0.9600	0.9600	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	32204	CLORETO DE SODIO 0,9% 10 ML SI IV AP	0.4800	0.0000	0.4800	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	32204	CLORETO DE SODIO 0,9% 10 ML SI IV AP	0.4800	0.0000	0.4800	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	32204	CLORETO DE SODIO 0,9% 10 ML SI IV AP	0.4800	0.0000	0.4800	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	e715e2ae28a6229c8609756d3298bf52	MARIA	12734221144	NULL	12734221144	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1750	0.0050	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	05975	COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER	0.3000	0.0000	0.3000	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	05975	COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER	0.6000	0.7667	-0.1667	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	05975	COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER	0.3000	0.1918	0.1082	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	05975	COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER	0.6000	0.7673	-0.1673	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	33537	PIPERACILINA 2 G + TAZOBACTAM 250 MG 30 ML	55.3400	55.3375	0.0025	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	33537	PIPERACILINA 2 G + TAZOBACTAM 250 MG 30 ML	55.3400	55.3375	0.0025	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	33537	PIPERACILINA 2 G + TAZOBACTAM 250 MG 30 ML	55.3400	55.3375	0.0025	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	33537	PIPERACILINA 2 G + TAZOBACTAM 250 MG 30 ML	55.3400	55.3375	0.0025	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	33537	PIPERACILINA 2 G + TAZOBACTAM 250 MG 30 ML	55.3400	55.3375	0.0025	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	42358	FUROSEMIDA 10 MG/ML 2 ML SI IM IV AP	1.2000	1.1964	0.0036	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4061	0.0039	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4061	0.0039	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4061	0.0039	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4061	0.0039	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	33227	LUVA CIRURGICA PAR UN	1.4500	1.4477	0.0023	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	33227	LUVA CIRURGICA PAR UN	1.4500	1.4477	0.0023	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	33227	LUVA CIRURGICA PAR UN	1.4500	1.4477	0.0023	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	33227	LUVA CIRURGICA PAR UN	1.4500	1.4477	0.0023	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	08664	ESPARADRAPO MICROPORE 50 X 10 CM CM	0.7700	0.0000	0.7700	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	08664	ESPARADRAPO MICROPORE 50 X 10 CM CM	0.7700	0.7650	0.0050	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	19135	SERINGA DESC 03 ML UN	0.1500	0.1500	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.2100	0.2057	0.0043	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.2100	0.2057	0.0043	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1772	0.0028	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1772	0.0028	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1772	0.0028	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1772	0.0028	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1772	0.0028	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	cd2840524be5a3f1d0939f241e24f32b	MARIA	12705908340	NULL	12705908340	32204	CLORETO DE SODIO 0,9% 10 ML SI IV AP	0.4800	0.0000	0.4800	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	cd2840524be5a3f1d0939f241e24f32b	MARIA	12705908340	NULL	12705908340	32204	CLORETO DE SODIO 0,9% 10 ML SI IV AP	0.4800	0.4800	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	cd2840524be5a3f1d0939f241e24f32b	MARIA	12705908340	NULL	12705908340	32204	CLORETO DE SODIO 0,9% 10 ML SI IV AP	0.4800	0.0000	0.4800	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	cd2840524be5a3f1d0939f241e24f32b	MARIA	12705908340	NULL	12705908340	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1764	0.0036	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	cd2840524be5a3f1d0939f241e24f32b	MARIA	12705908340	NULL	12705908340	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1764	0.0036	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	cd2840524be5a3f1d0939f241e24f32b	MARIA	12705908340	NULL	12705908340	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1764	0.0036	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	d17b3c5ae418d82694895a326dee545a	ODILIA	12670516743	NULL	12670516743	30376	BROMETO DE IPRATROPIO 0,25MG/ML SL IN GT	0.4000	0.0000	0.4000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	d17b3c5ae418d82694895a326dee545a	ODILIA	12670516743	NULL	12670516743	30376	BROMETO DE IPRATROPIO 0,25MG/ML SL IN GT	0.4000	0.0000	0.4000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	d17b3c5ae418d82694895a326dee545a	ODILIA	12670516743	NULL	12670516743	32204	CLORETO DE SODIO 0,9% 10 ML SI IV AP	0.4800	0.0000	0.4800	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1766	0.0034	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1766	0.0034	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1766	0.0034	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1766	0.0034	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1766	0.0034	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	8a5ecfde671848d05ac757e0112e689c	TEREZINHA	12700337042	NULL	12700337042	09733	ACETILCISTEINA 600MG PO VO SA	3.5000	3.4967	0.0033	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	8a5ecfde671848d05ac757e0112e689c	TEREZINHA	12700337042	NULL	12700337042	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4071	0.0029	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	8a5ecfde671848d05ac757e0112e689c	TEREZINHA	12700337042	NULL	12700337042	19160	SERINGA DESC 20 ML UN	0.5400	0.5376	0.0024	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	8a5ecfde671848d05ac757e0112e689c	TEREZINHA	12700337042	NULL	12700337042	19160	SERINGA DESC 20 ML UN	0.5400	0.5376	0.0024	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	8a5ecfde671848d05ac757e0112e689c	TEREZINHA	12700337042	NULL	12700337042	19160	SERINGA DESC 20 ML UN	0.5400	0.5376	0.0024	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	8a5ecfde671848d05ac757e0112e689c	TEREZINHA	12700337042	NULL	12700337042	19160	SERINGA DESC 20 ML UN	0.5400	0.5376	0.0024	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	8a5ecfde671848d05ac757e0112e689c	TEREZINHA	12700337042	NULL	12700337042	19160	SERINGA DESC 20 ML UN	0.5400	0.5376	0.0024	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	8a5ecfde671848d05ac757e0112e689c	TEREZINHA	12700337042	NULL	12700337042	19160	SERINGA DESC 20 ML UN	0.5400	0.5376	0.0024	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	8a5ecfde671848d05ac757e0112e689c	TEREZINHA	12700337042	NULL	12700337042	19160	SERINGA DESC 20 ML UN	0.5400	0.5376	0.0024	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	70cf23c63f890f0b61da2542c3e13a09	TIAGO	12741864645	NULL	12741864645	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1762	0.0038	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	70cf23c63f890f0b61da2542c3e13a09	TIAGO	12741864645	NULL	12741864645	19160	SERINGA DESC 20 ML UN	0.5400	0.5367	0.0033	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	70cf23c63f890f0b61da2542c3e13a09	TIAGO	12741864645	NULL	12741864645	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4075	0.0025	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	70cf23c63f890f0b61da2542c3e13a09	TIAGO	12741864645	NULL	12741864645	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4075	0.0025	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	08648	ESPARADRAPO 10 X 4.5 CM CM	0.4000	0.0000	0.4000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4070	0.0030	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4070	0.0030	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	33227	LUVA CIRURGICA PAR UN	1.4500	1.4476	0.0024	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	33227	LUVA CIRURGICA PAR UN	1.4500	1.4476	0.0024	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	0111beed375944f60c7ad4a7fd4874f8	WALDIR	12746025744	NULL	12746025744	00426	AGUA BIDESTILADA 10 ML SI IV IM AP	0.8100	0.8074	0.0026	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	0111beed375944f60c7ad4a7fd4874f8	WALDIR	12746025744	NULL	12746025744	00426	AGUA BIDESTILADA 10 ML SI IV IM AP	1.6200	1.6147	0.0053	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	0111beed375944f60c7ad4a7fd4874f8	WALDIR	12746025744	NULL	12746025744	00426	AGUA BIDESTILADA 10 ML SI IV IM AP	1.6200	1.6147	0.0053	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	0111beed375944f60c7ad4a7fd4874f8	WALDIR	12746025744	NULL	12746025744	00426	AGUA BIDESTILADA 10 ML SI IV IM AP	1.6200	1.6147	0.0053	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	0111beed375944f60c7ad4a7fd4874f8	WALDIR	12746025744	NULL	12746025744	00426	AGUA BIDESTILADA 10 ML SI IV IM AP	1.6200	1.6147	0.0053	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	0111beed375944f60c7ad4a7fd4874f8	WALDIR	12746025744	NULL	12746025744	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4076	0.0024	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	0111beed375944f60c7ad4a7fd4874f8	WALDIR	12746025744	NULL	12746025744	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4076	0.0024	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	0111beed375944f60c7ad4a7fd4874f8	WALDIR	12746025744	NULL	12746025744	19160	SERINGA DESC 20 ML UN	0.5400	0.5379	0.0021	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	0111beed375944f60c7ad4a7fd4874f8	WALDIR	12746025744	NULL	12746025744	19160	SERINGA DESC 20 ML UN	0.5400	0.5379	0.0021	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	0111beed375944f60c7ad4a7fd4874f8	WALDIR	12746025744	NULL	12746025744	19160	SERINGA DESC 20 ML UN	0.5400	0.5379	0.0021	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	0111beed375944f60c7ad4a7fd4874f8	WALDIR	12746025744	NULL	12746025744	19160	SERINGA DESC 20 ML UN	0.5400	0.5379	0.0021	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	37761	ALCOOL ETILICO 70 % ST TP ML	0.0300	0.0000	0.0300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	37761	ALCOOL ETILICO 70 % ST TP ML	0.0600	0.0600	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	00817	ALGODAO HIDROFILO BOLINHA UN	0.2600	0.0000	0.2600	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	00817	ALGODAO HIDROFILO BOLINHA UN	0.5100	0.2600	0.2500	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	52353	ABAIXADOR DE LINGUA UN	0.0500	0.0267	0.0233	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	00817	ALGODAO HIDROFILO BOLINHA UN	0.2600	0.0000	0.2600	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	37761	ALCOOL ETILICO 70 % ST TP ML	0.0300	0.0000	0.0300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	00817	ALGODAO HIDROFILO BOLINHA UN	0.2600	0.0000	0.2600	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	27596	TIRA TESTE PARA GLICOSE UN	1.0400	1.0400	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	05975	COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER	0.3000	0.0000	0.3000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	05975	COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER	0.3000	0.3000	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	05975	COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER	0.3000	0.0000	0.3000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12647284040	NULL	12647284040	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4086	0.0014	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12662414945	NULL	12662414945	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1750	0.0050	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12662414945	NULL	12662414945	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1750	0.0050	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12662414945	NULL	12662414945	33219	LUVA DE PROCEDIMENTO UNIDADE UN	0.6700	0.6657	0.0043	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12662414945	NULL	12662414945	13404	OMEPRAZOL 40 MG + DIL. 10 ML PO IV FA	19.5800	19.5750	0.0050	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12662414945	NULL	12662414945	19445	CLORETO DE POTASSIO 600 MG CA VO UN	0.4900	0.4867	0.0033	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12579183644	NULL	12579183644	05975	COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER	0.3000	0.0000	0.3000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12579183644	NULL	12579183644	05975	COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER	0.3000	0.0000	0.3000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12579183644	NULL	12579183644	05975	COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER	0.3000	0.0000	0.3000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12579183644	NULL	12579183644	05975	COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER	0.3000	0.0000	0.3000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12579183644	NULL	12579183644	33227	LUVA CIRURGICA PAR UN	1.4500	1.4460	0.0040	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12579183644	NULL	12579183644	33227	LUVA CIRURGICA PAR UN	1.4500	1.4476	0.0024	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12579183644	NULL	12579183644	33227	LUVA CIRURGICA PAR UN	1.4500	1.4476	0.0024	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	33219	LUVA DE PROCEDIMENTO UNIDADE UN	0.3300	0.0000	0.3300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	33219	LUVA DE PROCEDIMENTO UNIDADE UN	1.6700	1.6700	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1770	0.0030	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1770	0.0030	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1770	0.0030	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1770	0.0030	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1770	0.0030	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1770	0.0030	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1770	0.0030	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1770	0.0030	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1770	0.0030	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	26981	SORO FISIOLOGICO 0,9% 10 ML SI IV AP	0.0000	0.9600	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	26981	SORO FISIOLOGICO 0,9% 10 ML SI IV AP	0.0000	0.9600	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	26981	SORO FISIOLOGICO 0,9% 10 ML SI IV AP	0.0000	0.9600	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	ea4ad2636c25d8e3dbb569ae62db71e7	IONE	12489788840	NULL	12489788840	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.0000	0.4000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	ea4ad2636c25d8e3dbb569ae62db71e7	IONE	12489788840	NULL	12489788840	00737	CEFTRIAXONA IV 1G + DIL. 10 ML PO IV FA	0.0000	27.0600	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	ea4ad2636c25d8e3dbb569ae62db71e7	IONE	12489788840	NULL	12489788840	00737	CEFTRIAXONA IV 1G + DIL. 10 ML PO IV FA	0.0000	27.0600	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	d17b3c5ae418d82694895a326dee545a	ODILIA	12670516743	NULL	12670516743	102001	DIARIA DE APARTAMENTO	0.0000	288.8881	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	d17b3c5ae418d82694895a326dee545a	ODILIA	12670516743	NULL	12670516743	102001	DIARIA DE APARTAMENTO	0.0000	288.8882	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	d17b3c5ae418d82694895a326dee545a	ODILIA	12670516743	NULL	12670516743	00124	LUVA CIRURGICA UN	0.0000	1.4500	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	d17b3c5ae418d82694895a326dee545a	ODILIA	12670516743	NULL	12670516743	02197	METAMUCIL (PLANTAGO OVATA) 3,4 G PO VO EV	0.0000	2.4600	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	d17b3c5ae418d82694895a326dee545a	ODILIA	12670516743	NULL	12670516743	02197	METAMUCIL (PLANTAGO OVATA) 3,4 G PO VO EV	0.0000	2.4600	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	d17b3c5ae418d82694895a326dee545a	ODILIA	12670516743	NULL	12670516743	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1965b0cdebe9017c3397c8641147759	JOSE	12705413746	NULL	12705413746	102001	DIARIA DE APARTAMENTO	0.0000	288.8882	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1965b0cdebe9017c3397c8641147759	JOSE	12705413746	NULL	12705413746	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4074	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1965b0cdebe9017c3397c8641147759	JOSE	12705413746	NULL	12705413746	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4074	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1965b0cdebe9017c3397c8641147759	JOSE	12705413746	NULL	12705413746	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4074	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	01611	CLORETO DE POTASSIO 600 MG CA VO UN	0.0000	0.4867	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	02246	HIDROCORTISONA 100 MG PO IM IV FA	0.0000	2.8300	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	02246	HIDROCORTISONA 100 MG PO IM IV FA	0.0000	2.8300	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	02246	HIDROCORTISONA 100 MG PO IM IV FA	0.0000	2.8300	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	02246	HIDROCORTISONA 100 MG PO IM IV FA	0.0000	2.8300	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	02246	HIDROCORTISONA 100 MG PO IM IV FA	0.0000	2.8300	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	26981	SORO FISIOLOGICO 0,9% 10 ML SI IV AP	0.0000	0.4800	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	26981	SORO FISIOLOGICO 0,9% 10 ML SI IV AP	0.0000	0.4800	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	26981	SORO FISIOLOGICO 0,9% 10 ML SI IV AP	0.0000	0.4800	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	26981	SORO FISIOLOGICO 0,9% 10 ML SI IV AP	0.0000	0.4800	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	26981	SORO FISIOLOGICO 0,9% 10 ML SI IV AP	0.0000	0.4800	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	00404	LACTULOSE 667 MG/ML XP VO ML	0.0000	6.4300	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	00404	LACTULOSE 667 MG/ML XP VO ML	0.0000	6.4300	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	00404	LACTULOSE 667 MG/ML XP VO ML	0.0000	6.4300	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	000451	TAXA DE ALIMENTACAO PARA ACOMPANHANTES - 3 REFEICO	0.0000	0.0000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	00487	RANITIDINA 25 MG/ML 2 ML SI IM IV AP	0.0000	0.9300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1800	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1771	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1771	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1771	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1771	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1771	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1771	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1771	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1771	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1771	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1771	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1771	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1771	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1771	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1771	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	081fdadb830fb547e83c43fabdb88372	ELZA	12377335349	NULL	12377335349	51240	FITA ADVANTAGE P/ GLICOSE UN	0.0000	2.5900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	081fdadb830fb547e83c43fabdb88372	ELZA	12377335349	NULL	12377335349	51240	FITA ADVANTAGE P/ GLICOSE UN	0.0000	2.5900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	081fdadb830fb547e83c43fabdb88372	ELZA	12377335349	NULL	12377335349	09071	ACETILCISTEINA 600MG PO VO SA	0.0000	3.5000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	081fdadb830fb547e83c43fabdb88372	ELZA	12377335349	NULL	12377335349	09071	ACETILCISTEINA 600MG PO VO SA	0.0000	3.5000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	081fdadb830fb547e83c43fabdb88372	ELZA	12377335349	NULL	12377335349	09071	ACETILCISTEINA 600MG PO VO SA	0.0000	3.5000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	081fdadb830fb547e83c43fabdb88372	ELZA	12377335349	NULL	12377335349	09071	ACETILCISTEINA 600MG PO VO SA	0.0000	3.5000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	24571	CLINDAMICINA 600 MG 4 ML SI IM IV AP	0.0000	13.0800	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	24571	CLINDAMICINA 600 MG 4 ML SI IM IV AP	0.0000	13.0800	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	24571	CLINDAMICINA 600 MG 4 ML SI IM IV AP	0.0000	13.0800	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	24571	CLINDAMICINA 600 MG 4 ML SI IM IV AP	0.0000	13.0800	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	24571	CLINDAMICINA 600 MG 4 ML SI IM IV AP	0.0000	13.0800	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	24571	CLINDAMICINA 600 MG 4 ML SI IM IV AP	0.0000	13.0800	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	24571	CLINDAMICINA 600 MG 4 ML SI IM IV AP	0.0000	13.0800	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	dd486d36a88cfef0b44fe652638a0164	DELFINA	12660326244	NULL	12660326244	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	dd486d36a88cfef0b44fe652638a0164	DELFINA	12660326244	NULL	12660326244	14191	OMEPRAZOL 20 MG CA VO UN	0.0000	0.9000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	dd486d36a88cfef0b44fe652638a0164	DELFINA	12660326244	NULL	12660326244	14191	OMEPRAZOL 20 MG CA VO UN	0.0000	0.9000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	dd486d36a88cfef0b44fe652638a0164	DELFINA	12660326244	NULL	12660326244	35382	COMPRESSAS DE GASES 7.5 X7,5 (11 FIOS ESTERIL) UN	0.0000	0.3000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	dd486d36a88cfef0b44fe652638a0164	DELFINA	12660326244	NULL	12660326244	00406	FUROSEMIDA 10 MG/ML 2 ML SI IM IV AP	0.0000	0.6000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	dd486d36a88cfef0b44fe652638a0164	DELFINA	12660326244	NULL	12660326244	00487	RANITIDINA 25 MG/ML 2 ML SI IM IV AP	0.0000	0.9300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	dd486d36a88cfef0b44fe652638a0164	DELFINA	12660326244	NULL	12660326244	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.0000	0.4000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	dd486d36a88cfef0b44fe652638a0164	DELFINA	12660326244	NULL	12660326244	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.0000	0.8100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	dd486d36a88cfef0b44fe652638a0164	DELFINA	12660326244	NULL	12660326244	51379	SERINGA DESC 05 ML UN	0.0000	0.1900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	dd486d36a88cfef0b44fe652638a0164	DELFINA	12660326244	NULL	12660326244	51379	SERINGA DESC 05 ML UN	0.0000	0.1900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	dd486d36a88cfef0b44fe652638a0164	DELFINA	12660326244	NULL	12660326244	51379	SERINGA DESC 05 ML UN	0.0000	0.1900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	dd486d36a88cfef0b44fe652638a0164	DELFINA	12660326244	NULL	12660326244	51379	SERINGA DESC 05 ML UN	0.0000	0.1900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	dd486d36a88cfef0b44fe652638a0164	DELFINA	12660326244	NULL	12660326244	51588	ESPARADRAPO MICROPORE 50 X 10 CM CM	0.0000	0.7700	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	dd486d36a88cfef0b44fe652638a0164	DELFINA	12660326244	NULL	12660326244	00541	AMIODARONA 200 MG CP VO UN	0.0000	0.8400	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	dd486d36a88cfef0b44fe652638a0164	DELFINA	12660326244	NULL	12660326244	06400	CARVEDILOL 3,125 MG CP VO UN	0.0000	0.7300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	102001	DIARIA DE APARTAMENTO	0.0000	288.8900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	00128	LUVA DE PROCEDIMENTO UNIDADE UN	0.0000	1.0000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	51589	ESPARADRAPO 10 X 4.5 CM CM	0.0000	0.4000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	51589	ESPARADRAPO 10 X 4.5 CM CM	0.0000	0.4000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	51649	ALCOOL ETILICO 70 % ST TP ML	0.0000	0.0300	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	51649	ALCOOL ETILICO 70 % ST TP ML	0.0000	0.0300	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	51649	ALCOOL ETILICO 70 % ST TP ML	0.0000	0.0300	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	51649	ALCOOL ETILICO 70 % ST TP ML	0.0000	0.0300	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	00090	SERINGA DESC 20 ML UN	0.0000	0.5400	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	00090	SERINGA DESC 20 ML UN	0.0000	0.5400	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	00090	SERINGA DESC 20 ML UN	0.0000	0.5400	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	00919	ALGODAO HIDROFILO BOLINHA UN	0.0000	0.2600	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	00943	EQUIPO POLIFIX 2 VIAS UN	0.0000	2.5500	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	f3ad474c8c562757c4d1a959ff0961c4	DJALMA	12718763240	NULL	12718763240	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	f3ad474c8c562757c4d1a959ff0961c4	DJALMA	12718763240	NULL	12718763240	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	f3ad474c8c562757c4d1a959ff0961c4	DJALMA	12718763240	NULL	12718763240	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	f3ad474c8c562757c4d1a959ff0961c4	DJALMA	12718763240	NULL	12718763240	00037	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	f3ad474c8c562757c4d1a959ff0961c4	DJALMA	12718763240	NULL	12718763240	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1800	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	f3ad474c8c562757c4d1a959ff0961c4	DJALMA	12718763240	NULL	12718763240	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1800	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	f3ad474c8c562757c4d1a959ff0961c4	DJALMA	12718763240	NULL	12718763240	00904	NORIPURUM EV 20 MG/ML 5 ML SI IV AP	0.0000	18.7700	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	f3ad474c8c562757c4d1a959ff0961c4	DJALMA	12718763240	NULL	12718763240	00090	SERINGA DESC 20 ML UN	0.0000	0.5400	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3fb5c891f31bb9efcb05395066127c52	ALAIDE	12636273441	NULL	12636273441	14250	PARACETAMOL 750 MG CP VO UN	0.0000	0.4500	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3fb5c891f31bb9efcb05395066127c52	ALAIDE	12636273441	NULL	12636273441	26981	SORO FISIOLOGICO 0,9% 10 ML SI IV AP	0.0000	0.0000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00090	SERINGA DESC 20 ML UN	0.5400	0.2200	0.3200	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00090	SERINGA DESC 20 ML UN	0.5400	0.2200	0.3200	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00090	SERINGA DESC 20 ML UN	0.5400	0.2200	0.3200	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00090	SERINGA DESC 20 ML UN	0.5400	0.2200	0.3200	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.6900	0.2700	0.4200	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.6900	0.2700	0.4200	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00493	BROMOPRIDA 5 MG/ML 2 ML SI IM IV AP	2.7300	1.0600	1.6700	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00493	BROMOPRIDA 5 MG/ML 2 ML SI IM IV AP	2.7300	1.0600	1.6700	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00493	BROMOPRIDA 5 MG/ML 2 ML SI IM IV AP	2.7300	1.0600	1.6700	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00493	BROMOPRIDA 5 MG/ML 2 ML SI IM IV AP	2.7300	1.0600	1.6700	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00493	BROMOPRIDA 5 MG/ML 2 ML SI IM IV AP	2.7300	1.0600	1.6700	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00124	LUVA CIRURGICA UN	2.9000	1.1300	1.7700	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	51163	AGUA BIDESTILADA 250 ML	5.7900	2.2600	3.5300	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	51163	AGUA BIDESTILADA 250 ML	5.7900	2.2600	3.5300	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	53144	TRAMAL	5.9900	2.3300	3.6600	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	53144	TRAMAL	5.9900	2.3300	3.6600	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	53144	TRAMAL	5.9900	2.3300	3.6600	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00613	CLINDAMICINA 600 MG 4 ML SI IM IV AP	13.0800	5.1000	7.9800	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	16b1e9f62f247f02ad5cac910ee15b4e	BERCHOLINA	12631612848	NULL	12631612848	33219	LUVA DE PROCEDIMENTO UNIDADE UN	1.0000	1.1687	-0.1687	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	16b1e9f62f247f02ad5cac910ee15b4e	BERCHOLINA	12631612848	NULL	12631612848	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4081	0.0019	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	16b1e9f62f247f02ad5cac910ee15b4e	BERCHOLINA	12631612848	NULL	12631612848	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4081	0.0019	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	16b1e9f62f247f02ad5cac910ee15b4e	BERCHOLINA	12631612848	NULL	12631612848	19160	SERINGA DESC 20 ML UN	0.5400	0.5385	0.0015	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	16b1e9f62f247f02ad5cac910ee15b4e	BERCHOLINA	12631612848	NULL	12631612848	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1900	0.1781	0.0119	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	16b1e9f62f247f02ad5cac910ee15b4e	BERCHOLINA	12631612848	NULL	12631612848	33219	LUVA DE PROCEDIMENTO UNIDADE UN	0.8370	1.0018	-0.3318	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	16b1e9f62f247f02ad5cac910ee15b4e	BERCHOLINA	12631612848	NULL	12631612848	00090	SERINGA DESC 20 ML UN	0.5400	0.5200	0.0200	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	16b1e9f62f247f02ad5cac910ee15b4e	BERCHOLINA	12631612848	NULL	12631612848	00090	SERINGA DESC 20 ML UN	0.5400	0.5200	0.0200	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	16b1e9f62f247f02ad5cac910ee15b4e	BERCHOLINA	12631612848	NULL	12631612848	00090	SERINGA DESC 20 ML UN	0.5400	0.5200	0.0200	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	16b1e9f62f247f02ad5cac910ee15b4e	BERCHOLINA	12631612848	NULL	12631612848	00406	FUROSEMIDA 10 MG/ML 2 ML SI IM IV AP	1.2000	1.1500	0.0500	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	16b1e9f62f247f02ad5cac910ee15b4e	BERCHOLINA	12631612848	NULL	12631612848	00171	SORO FISIOLOGICO 0,9% 250 ML SI IV BS	3.9400	3.7600	0.1800	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	33219	LUVA DE PROCEDIMENTO UNIDADE UN	1.6700	0.0000	1.6700	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	31d18d6607d9e742c53e748d6a55d740	CARLOS	12557779343	NULL	12557779343	37761	ALCOOL ETILICO 70 % ST TP ML	0.0600	0.0300	0.0300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	00817	ALGODAO HIDROFILO BOLINHA UN	0.2600	0.1300	0.1300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	33219	LUVA DE PROCEDIMENTO UNIDADE UN	1.0000	0.6700	0.3300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	9ffbbf7340bbd65e9e3baa9406d027f3	MARCO	12261811645	NULL	12261811645	53660	EQUIPO MACRO-GOTAS FLEXIVEL C/ INJETOR LATE	1.5900	0.0000	1.5900	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	5f044434edae42d3d17c4392018c7824	DINORA	12673932742	NULL	12673932742	20567	SORO FISIOLOGICO 0,9% 500 ML SI IV BS	4.7300	0.0000	4.7300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	d4089ccef13567fd45b16fb0b60685fa	VERA	12656425943	NULL	12656425943	33219	LUVA DE PROCEDIMENTO UNIDADE UN	1.6700	0.6700	1.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	edffb7fef608512400078fdf75991573	CARLA	12728631049	NULL	12728631049	19216	SEVOFLURANO 1 ML/ML (100%) SL IN ML	301.8000	176.0500	125.7500	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	dd6f8d6c53ffe9bfd3aa9590ba500cc8	ILDA	12751932542	NULL	12751932542	33219	LUVA DE PROCEDIMENTO UNIDADE UN	3.3300	1.6700	1.6600	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	37761	ALCOOL ETILICO 70 % ST TP ML	0.0600	0.0300	0.0300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	33219	LUVA DE PROCEDIMENTO UNIDADE UN	1.0000	0.6700	0.3300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	33219	LUVA DE PROCEDIMENTO UNIDADE UN	1.0000	0.6700	0.3300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	33219	LUVA DE PROCEDIMENTO UNIDADE UN	1.0000	0.6700	0.3300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	12750	LAMINA BISTURI N 10, 11,12 E 15 UN	2.2000	1.1000	1.1000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	19160	SERINGA DESC 20 ML UN	0.5400	0.0000	0.5400	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	00817	ALGODAO HIDROFILO BOLINHA UN	0.5100	0.2600	0.2500	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	cd2840524be5a3f1d0939f241e24f32b	MARIA	12705908340	NULL	12705908340	33219	LUVA DE PROCEDIMENTO UNIDADE UN	1.0000	0.6700	0.3300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	cd2840524be5a3f1d0939f241e24f32b	MARIA	12705908340	NULL	12705908340	00817	ALGODAO HIDROFILO BOLINHA UN	0.2600	0.1300	0.1300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	cd2840524be5a3f1d0939f241e24f32b	MARIA	12705908340	NULL	12705908340	37761	ALCOOL ETILICO 70 % ST TP ML	0.0300	0.0200	0.0100	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	cd2840524be5a3f1d0939f241e24f32b	MARIA	12705908340	NULL	12705908340	33219	LUVA DE PROCEDIMENTO UNIDADE UN	1.0000	0.6700	0.3300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	cd2840524be5a3f1d0939f241e24f32b	MARIA	12705908340	NULL	12705908340	30376	BROMETO DE IPRATROPIO 0,25MG/ML SL IN GT	1.2000	0.0000	1.2000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12603877940	NULL	12603877940	11134	HEPARINA 5000 UI/ML 5 ML SI IV SC ML	2.8800	0.7200	2.1600	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12603877940	NULL	12603877940	30651	CIPROFLOXACINO 2 MG/ML 100 ML SI IV BS	80.1700	0.0000	80.1700	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12603877940	NULL	12603877940	37761	ALCOOL ETILICO 70 % ST TP ML	0.0300	0.0200	0.0100	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12603877940	NULL	12603877940	19151	SERINGA DESC 10 ML UN	2.0000	0.0000	2.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12603877940	NULL	12603877940	55018	ALGINATO DE CALCIO EM HIDROGEL GL TP GR	20.7000	13.8000	6.9000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	08648	ESPARADRAPO 10 X 4.5 CM CM	0.4000	0.2000	0.2000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	02461	FENOTEROL 2 MG/ML 10 ML AE IN DS	2.5500	0.0000	2.5500	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	d4089ccef13567fd45b16fb0b60685fa	VERA	12656425943	NULL	12656425943	25040014	ASSISTENCIA FISIATRICA RESPIRATORIA	0.0000	5.0300	NULL	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	818a6f2e549cc6a60aa20f9d0595eec9	ANTONIO	12565134343	NULL	12565134343	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1767	0.0033	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	a050ed50115d2a6dd0b15b99b39063da	ARI	12676101147	NULL	12676101147	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1750	0.0050	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	a050ed50115d2a6dd0b15b99b39063da	ARI	12676101147	NULL	12676101147	19160	SERINGA DESC 20 ML UN	0.5400	0.5367	0.0033	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	edffb7fef608512400078fdf75991573	CARLA	12728631049	NULL	12728631049	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1760	0.0040	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	edffb7fef608512400078fdf75991573	CARLA	12728631049	NULL	12728631049	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1760	0.0040	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	39df67956a358bf1eab89803158d25dd	HELENA	12655863342	NULL	12655863342	08664	ESPARADRAPO MICROPORE 50 X 10 CM CM	0.7700	0.7600	0.0000	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	39df67956a358bf1eab89803158d25dd	HELENA	12655863342	NULL	12655863342	33219	LUVA DE PROCEDIMENTO UNIDADE UN	1.6700	1.6647	0.0053	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	cb57fc8e673b7c8bc339e1fe25d70cd5	HELIO	12661165148	NULL	12661165148	07269	DIPIRONA 500 MG/ML 2 ML SI IV IM AP	0.6900	0.6867	0.0033	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	9d06dbe3a8516628c3a045963dfb9c42	INAN	12623574546	NULL	12623574546	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1757	0.0043	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	4668d2494ed6c4b2d18be299efcb26a2	JOAO	12469689344	NULL	12469689344	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1700	0.0000	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	4668d2494ed6c4b2d18be299efcb26a2	JOAO	12469689344	NULL	12469689344	07269	DIPIRONA 500 MG/ML 2 ML SI IV IM AP	2.7500	2.7400	0.0000	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	4668d2494ed6c4b2d18be299efcb26a2	JOAO	12469689344	NULL	12469689344	17817	PROLOPA (LEVODOPA 200 MG + BENSERAZIDA 50 M	2.1200	2.1150	0.0050	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	d4089ccef13567fd45b16fb0b60685fa	VERA	12640482546	NULL	12640482546	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1754	0.0046	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	01081197	5b1e846d62341272eec7cc65f2fed2e7	ANGELIA	12734669220	NULL	12734669220	32050038	TORAX PA	0.0000	11.0271	NULL	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	20cbe2e07b1dcd2b6af609a50df7ae80	LUCELENA	12690767849	NULL	12690767849	000501	OXIGENIO	0.0000	1023.0000	NULL	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	25030019	DISTURBIOS CIRCULATORIOS ARTERIO VE	0.0000	126.1000	NULL	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	cd8240dfed3b190f93e1f35f15f53916	WANDELCY	12756680448	NULL	12756680448	25030019	DISTURBIOS CIRCULATORIOS ARTERIO VE	0.0000	0.0000	NULL	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	de1a8276d878171456d7fc8f6dcd2457	ABEL	12764206443	NULL	12764206443	00426	AGUA BIDESTILADA 10 ML SI IV IM AP	0.8100	0.8067	0.0033	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	de1a8276d878171456d7fc8f6dcd2457	ABEL	12764206443	NULL	12764206443	07269	DIPIRONA 500 MG/ML 2 ML SI IV IM AP	0.6900	0.6867	0.0033	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	de1a8276d878171456d7fc8f6dcd2457	ABEL	12764206443	NULL	12764206443	07269	DIPIRONA 500 MG/ML 2 ML SI IV IM AP	0.6900	0.6860	0.0040	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	eecb3d883747b059c3fe231c34567476	AFFRIDES	12693180144	NULL	12693180144	31585	RANITIDINA 25 MG/ML 2 ML SI IV IM AP	1.8700	1.8667	0.0033	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	eecb3d883747b059c3fe231c34567476	AFFRIDES	12693180144	NULL	12693180144	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1780	0.0020	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	eecb3d883747b059c3fe231c34567476	AFFRIDES	12693180144	NULL	12693180144	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1770	0.0030	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	eecb3d883747b059c3fe231c34567476	AFFRIDES	12693180144	NULL	12693180144	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1770	0.0030	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	eecb3d883747b059c3fe231c34567476	AFFRIDES	12693180144	NULL	12693180144	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1770	0.0030	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	eecb3d883747b059c3fe231c34567476	AFFRIDES	12693180144	NULL	12693180144	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1770	0.0030	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	eecb3d883747b059c3fe231c34567476	AFFRIDES	12693180144	NULL	12693180144	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1770	0.0030	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	eecb3d883747b059c3fe231c34567476	AFFRIDES	12693180144	NULL	12693180144	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1770	0.0030	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	eecb3d883747b059c3fe231c34567476	AFFRIDES	12693180144	NULL	12693180144	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1770	0.0030	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	eecb3d883747b059c3fe231c34567476	AFFRIDES	12693180144	NULL	12693180144	00426	AGUA BIDESTILADA 10 ML SI IV IM AP	0.8100	0.8072	0.0028	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	eecb3d883747b059c3fe231c34567476	AFFRIDES	12693180144	NULL	12693180144	09733	ACETILCISTEINA 600MG PO VO SA	3.5000	3.4955	0.0045	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	eecb3d883747b059c3fe231c34567476	AFFRIDES	12693180144	NULL	12693180144	09733	ACETILCISTEINA 600MG PO VO SA	3.5000	3.4955	0.0045	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	eecb3d883747b059c3fe231c34567476	AFFRIDES	12693180144	NULL	12693180144	09733	ACETILCISTEINA 600MG PO VO SA	3.5000	3.4955	0.0045	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	eecb3d883747b059c3fe231c34567476	AFFRIDES	12693180144	NULL	12693180144	09733	ACETILCISTEINA 600MG PO VO SA	3.5000	3.4955	0.0045	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	08664	ESPARADRAPO MICROPORE 50 X 10 CM CM	0.2600	0.2561	0.0039	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	08664	ESPARADRAPO MICROPORE 50 X 10 CM CM	0.7700	0.7682	0.0018	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	42358	FUROSEMIDA 10 MG/ML 2 ML SI IM IV AP	0.6000	0.5984	0.0016	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4078	0.0022	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4078	0.0022	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4078	0.0022	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4078	0.0022	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4078	0.0022	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4078	0.0022	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4078	0.0022	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4078	0.0022	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	33227	LUVA CIRURGICA PAR UN	1.4500	1.4492	0.0008	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	33227	LUVA CIRURGICA PAR UN	1.4500	1.4476	0.0024	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	33227	LUVA CIRURGICA PAR UN	1.4500	1.4476	0.0024	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.1038	-0.0038	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.1038	-0.0038	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.1038	-0.0038	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.1038	-0.0038	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	b288bbcfb9aecab51bcb0dba62ca0059	IVONETE	12743730847	NULL	12743730847	19160	SERINGA DESC 20 ML UN	0.5400	0.5367	0.0033	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	b288bbcfb9aecab51bcb0dba62ca0059	IVONETE	12743730847	NULL	12743730847	19160	SERINGA DESC 20 ML UN	0.5400	0.5367	0.0033	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1900	0.1900	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1800	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	00817	ALGODAO HIDROFILO BOLINHA UN	0.2600	0.1300	0.1300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4084	0.0016	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4084	0.0016	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4084	0.0016	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4084	0.0016	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4084	0.0016	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.1036	-0.0036	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.1036	-0.0036	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	2a79bf9d53875b480086bd7b8321c4f1	JOSE	12641066643	NULL	12641066643	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1700	0.0000	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	2a79bf9d53875b480086bd7b8321c4f1	JOSE	12641066643	NULL	12641066643	12262	ISOSSORBIDA 20 MG CP VO UN	0.2200	0.2167	0.0033	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	20cbe2e07b1dcd2b6af609a50df7ae80	LUCELENA	12690767849	NULL	12690767849	19160	SERINGA DESC 20 ML UN	0.5400	0.5384	0.0016	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	20cbe2e07b1dcd2b6af609a50df7ae80	LUCELENA	12690767849	NULL	12690767849	19160	SERINGA DESC 20 ML UN	0.5400	0.5384	0.0016	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	20cbe2e07b1dcd2b6af609a50df7ae80	LUCELENA	12690767849	NULL	12690767849	19160	SERINGA DESC 20 ML UN	0.5400	0.5384	0.0016	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	20cbe2e07b1dcd2b6af609a50df7ae80	LUCELENA	12690767849	NULL	12690767849	19160	SERINGA DESC 20 ML UN	0.5400	0.5384	0.0016	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	20cbe2e07b1dcd2b6af609a50df7ae80	LUCELENA	12690767849	NULL	12690767849	19160	SERINGA DESC 20 ML UN	0.5400	0.5384	0.0016	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	32204	CLORETO DE SODIO 0,9% 10 ML SI IV AP	0.4800	0.0000	0.4800	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	32204	CLORETO DE SODIO 0,9% 10 ML SI IV AP	0.4800	0.0000	0.4800	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	32204	CLORETO DE SODIO 0,9% 10 ML SI IV AP	0.4800	0.0000	0.4800	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	30376	BROMETO DE IPRATROPIO 0,25MG/ML SL IN GT	0.6000	0.0000	0.6000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	00426	AGUA BIDESTILADA 10 ML SI IV IM AP	0.8100	0.8067	0.0033	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	00426	AGUA BIDESTILADA 10 ML SI IV IM AP	0.8100	0.8067	0.0033	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	00426	AGUA BIDESTILADA 10 ML SI IV IM AP	0.8100	0.8067	0.0033	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	33219	LUVA DE PROCEDIMENTO UNIDADE UN	0.6700	0.0000	0.6700	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	33219	LUVA DE PROCEDIMENTO UNIDADE UN	1.0000	0.6700	0.3300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	32204	CLORETO DE SODIO 0,9% 10 ML SI IV AP	0.4800	0.0000	0.4800	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	53660	EQUIPO MACRO-GOTAS FLEXIVEL C/ INJETOR LATE	1.5900	0.0000	1.5900	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	14460	DOMPERIDONA 10 MG CP VO UN	0.3900	0.0000	0.3900	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	14460	DOMPERIDONA 10 MG CP VO UN	0.3900	0.0000	0.3900	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	32204	CLORETO DE SODIO 0,9% 10 ML SI IV AP	0.4800	0.0000	0.4800	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	32204	CLORETO DE SODIO 0,9% 10 ML SI IV AP	0.4800	0.0000	0.4800	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	32204	CLORETO DE SODIO 0,9% 10 ML SI IV AP	0.4800	0.0000	0.4800	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	e715e2ae28a6229c8609756d3298bf52	MARIA	12734221144	NULL	12734221144	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1750	0.0050	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	11193	CLOREXIDINA 2 % ST TP ML	0.2700	0.2650	0.0050	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	05975	COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER	0.3000	0.0000	0.3000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	05975	COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER	0.3000	0.3833	-0.0833	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	05975	COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER	0.3000	0.0000	0.3000	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	33537	PIPERACILINA 2 G + TAZOBACTAM 250 MG 30 ML	55.3400	55.3375	0.0025	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	33537	PIPERACILINA 2 G + TAZOBACTAM 250 MG 30 ML	55.3400	55.3375	0.0025	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	42358	FUROSEMIDA 10 MG/ML 2 ML SI IM IV AP	1.2000	1.1964	0.0036	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	42358	FUROSEMIDA 10 MG/ML 2 ML SI IM IV AP	1.2000	1.1964	0.0036	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	42358	FUROSEMIDA 10 MG/ML 2 ML SI IM IV AP	1.2000	1.1964	0.0036	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4061	0.0039	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4061	0.0039	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	33227	LUVA CIRURGICA PAR UN	1.4500	1.4477	0.0023	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	33227	LUVA CIRURGICA PAR UN	1.4500	1.4477	0.0023	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	33227	LUVA CIRURGICA PAR UN	1.4500	1.4477	0.0023	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	19135	SERINGA DESC 03 ML UN	0.1500	0.0000	0.1500	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	19135	SERINGA DESC 03 ML UN	0.1500	0.0000	0.1500	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	08664	ESPARADRAPO MICROPORE 50 X 10 CM CM	0.7700	0.0000	0.7700	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	19135	SERINGA DESC 03 ML UN	0.1500	0.0000	0.1500	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	19151	SERINGA DESC 10 ML UN	0.6700	0.6657	0.0043	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.2100	0.2057	0.0043	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1772	0.0028	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1772	0.0028	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1772	0.0028	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	08664	ESPARADRAPO MICROPORE 50 X 10 CM CM	0.7700	0.7670	0.0030	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	cd2840524be5a3f1d0939f241e24f32b	MARIA	12705908340	NULL	12705908340	32204	CLORETO DE SODIO 0,9% 10 ML SI IV AP	0.4800	0.0000	0.4800	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	cd2840524be5a3f1d0939f241e24f32b	MARIA	12705908340	NULL	12705908340	32204	CLORETO DE SODIO 0,9% 10 ML SI IV AP	0.4800	0.4800	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	cd2840524be5a3f1d0939f241e24f32b	MARIA	12705908340	NULL	12705908340	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1764	0.0036	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	a6786839bc6f6afb2125c1877c91c932	MARIA	12742515845	NULL	12742515845	102001	DIARIA DE APARTAMENTO SIMPLES	288.8900	288.8800	0.0000	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	d17b3c5ae418d82694895a326dee545a	ODILIA	12670516743	NULL	12670516743	30376	BROMETO DE IPRATROPIO 0,25MG/ML SL IN GT	0.4000	0.0000	0.4000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	d17b3c5ae418d82694895a326dee545a	ODILIA	12670516743	NULL	12670516743	32204	CLORETO DE SODIO 0,9% 10 ML SI IV AP	0.4800	0.0000	0.4800	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1766	0.0034	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1766	0.0034	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1766	0.0034	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1766	0.0034	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1766	0.0034	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1766	0.0034	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1766	0.0034	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	8a5ecfde671848d05ac757e0112e689c	TEREZINHA	12700337042	NULL	12700337042	10626	GLICOSE 50% 10 ML SI IV AP	2.7400	2.7350	0.0050	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	8a5ecfde671848d05ac757e0112e689c	TEREZINHA	12700337042	NULL	12700337042	10626	GLICOSE 50% 10 ML SI IV AP	2.7400	2.7350	0.0050	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	8a5ecfde671848d05ac757e0112e689c	TEREZINHA	12700337042	NULL	12700337042	10626	GLICOSE 50% 10 ML SI IV AP	2.7400	2.7350	0.0050	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	8a5ecfde671848d05ac757e0112e689c	TEREZINHA	12700337042	NULL	12700337042	57258	FUMARATO DE QUETIAPINA 25 MG CA VO UN	1.2500	1.2450	0.0050	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	8a5ecfde671848d05ac757e0112e689c	TEREZINHA	12700337042	NULL	12700337042	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4071	0.0029	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	8a5ecfde671848d05ac757e0112e689c	TEREZINHA	12700337042	NULL	12700337042	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4071	0.0029	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	8a5ecfde671848d05ac757e0112e689c	TEREZINHA	12700337042	NULL	12700337042	19160	SERINGA DESC 20 ML UN	0.5400	0.5376	0.0024	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	8a5ecfde671848d05ac757e0112e689c	TEREZINHA	12700337042	NULL	12700337042	19160	SERINGA DESC 20 ML UN	0.5400	0.5376	0.0024	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	70cf23c63f890f0b61da2542c3e13a09	TIAGO	12741864645	NULL	12741864645	50385	CETOPROFENO 100 MG PO IV FA	7.7800	7.7700	0.0000	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	70cf23c63f890f0b61da2542c3e13a09	TIAGO	12741864645	NULL	12741864645	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1762	0.0038	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	70cf23c63f890f0b61da2542c3e13a09	TIAGO	12741864645	NULL	12741864645	19160	SERINGA DESC 20 ML UN	0.5400	0.5367	0.0033	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	70cf23c63f890f0b61da2542c3e13a09	TIAGO	12741864645	NULL	12741864645	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4075	0.0025	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	70cf23c63f890f0b61da2542c3e13a09	TIAGO	12741864645	NULL	12741864645	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4075	0.0025	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	32204	CLORETO DE SODIO 0,9% 10 ML SI IV AP	0.9600	0.9600	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	08648	ESPARADRAPO 10 X 4.5 CM CM	0.4000	0.4000	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	0111beed375944f60c7ad4a7fd4874f8	WALDIR	12746025744	NULL	12746025744	00426	AGUA BIDESTILADA 10 ML SI IV IM AP	0.8100	0.8074	0.0026	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	0111beed375944f60c7ad4a7fd4874f8	WALDIR	12746025744	NULL	12746025744	00426	AGUA BIDESTILADA 10 ML SI IV IM AP	1.6200	1.6147	0.0053	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	0111beed375944f60c7ad4a7fd4874f8	WALDIR	12746025744	NULL	12746025744	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4076	0.0024	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	0111beed375944f60c7ad4a7fd4874f8	WALDIR	12746025744	NULL	12746025744	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4076	0.0024	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	0111beed375944f60c7ad4a7fd4874f8	WALDIR	12746025744	NULL	12746025744	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4076	0.0024	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	0111beed375944f60c7ad4a7fd4874f8	WALDIR	12746025744	NULL	12746025744	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4076	0.0024	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	0111beed375944f60c7ad4a7fd4874f8	WALDIR	12746025744	NULL	12746025744	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4076	0.0024	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	0111beed375944f60c7ad4a7fd4874f8	WALDIR	12746025744	NULL	12746025744	19160	SERINGA DESC 20 ML UN	0.5400	0.5379	0.0021	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	0111beed375944f60c7ad4a7fd4874f8	WALDIR	12746025744	NULL	12746025744	19160	SERINGA DESC 20 ML UN	0.5400	0.5379	0.0021	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	0111beed375944f60c7ad4a7fd4874f8	WALDIR	12746025744	NULL	12746025744	19160	SERINGA DESC 20 ML UN	0.5400	0.5379	0.0021	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	0111beed375944f60c7ad4a7fd4874f8	WALDIR	12746025744	NULL	12746025744	19160	SERINGA DESC 20 ML UN	0.5400	0.5379	0.0021	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	27596	TIRA TESTE PARA GLICOSE UN	1.0400	1.0400	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	27596	TIRA TESTE PARA GLICOSE UN	1.0400	1.0400	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	27596	TIRA TESTE PARA GLICOSE UN	1.0400	1.0400	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	05975	COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER	0.3000	0.0000	0.3000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12647284040	NULL	12647284040	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4086	0.0014	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12647284040	NULL	12647284040	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4086	0.0014	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12647284040	NULL	12647284040	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4086	0.0014	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12662414945	NULL	12662414945	19445	CLORETO DE POTASSIO 600 MG CA VO UN	0.4900	0.4864	0.0036	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12662414945	NULL	12662414945	42358	FUROSEMIDA 10 MG/ML 2 ML SI IM IV AP	1.2000	1.1967	0.0033	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12662414945	NULL	12662414945	42358	FUROSEMIDA 10 MG/ML 2 ML SI IM IV AP	1.2000	1.1967	0.0033	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12662414945	NULL	12662414945	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4071	0.0029	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12662414945	NULL	12662414945	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4071	0.0029	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12579183644	NULL	12579183644	05975	COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER	0.6000	0.6000	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12579183644	NULL	12579183644	05975	COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER	0.6000	0.6000	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12579183644	NULL	12579183644	05975	COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER	0.3000	0.0000	0.3000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12579183644	NULL	12579183644	05975	COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER	0.3000	0.1500	0.1500	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12579183644	NULL	12579183644	19160	SERINGA DESC 20 ML UN	1.0800	1.0733	0.0067	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12579183644	NULL	12579183644	33227	LUVA CIRURGICA PAR UN	1.4500	1.4476	0.0024	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12579183644	NULL	12579183644	33227	LUVA CIRURGICA PAR UN	1.4500	1.4476	0.0024	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12579183644	NULL	12579183644	33227	LUVA CIRURGICA PAR UN	1.4500	1.4476	0.0024	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12579183644	NULL	12579183644	33227	LUVA CIRURGICA PAR UN	1.4500	1.4476	0.0024	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12579183644	NULL	12579183644	33227	LUVA CIRURGICA PAR UN	1.4500	1.4476	0.0024	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12579183644	NULL	12579183644	33227	LUVA CIRURGICA PAR UN	1.4500	1.4476	0.0024	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	08435	EQUIPO P/ BOMBA DE INFUSAO ENTERAL / PARENT	20.2800	20.2800	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	33219	LUVA DE PROCEDIMENTO UNIDADE UN	0.3300	0.0000	0.3300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1770	0.0030	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1770	0.0030	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	NULL	0.0000	NULL	OPME INVALIDO	2201
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	00172	SORO FISIOLOGICO 0,9% 500 ML SI IV BS	NULL	0.0000	NULL	OPME INVALIDO	2201
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	34789	SONDA ASPIRAÇAO C/ VALVULA - TODAS - UTI UN	0.9400	0.9367	0.0033	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	34789	SONDA ASPIRAÇAO C/ VALVULA - TODAS - UTI UN	0.9400	0.9367	0.0033	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	33219	LUVA DE PROCEDIMENTO UNIDADE UN	1.0000	0.6700	0.3300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	37761	ALCOOL ETILICO 70 % ST TP ML	0.0300	0.0000	0.0300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00817	ALGODAO HIDROFILO BOLINHA UN	0.2600	0.1300	0.1300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	07269	DIPIRONA 500 MG/ML 2 ML SI IV IM AP	0.6900	0.0000	0.6900	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.2120	-0.1120	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.2120	-0.1120	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.2120	-0.1120	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.2120	-0.1120	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.1060	-0.0060	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.1060	-0.0060	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.1060	-0.0060	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.1060	-0.0060	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.1060	-0.0060	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.1060	-0.0060	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.1060	-0.0060	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.1060	-0.0060	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	34827	TIORFAN (RACECADOTRILA) 100 MG CA VO UN	3.2000	6.4000	-3.2000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	34827	TIORFAN (RACECADOTRILA) 100 MG CA VO UN	3.2000	6.4000	-3.2000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	34827	TIORFAN (RACECADOTRILA) 100 MG CA VO UN	3.2000	6.4000	-3.2000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	34827	TIORFAN (RACECADOTRILA) 100 MG CA VO UN	3.2000	3.2000	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	27596	TIRA TESTE PARA GLICOSE UN	1.0400	2.0800	-1.0400	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	19160	SERINGA DESC 20 ML UN	0.5400	0.5386	0.0014	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	19160	SERINGA DESC 20 ML UN	0.5400	0.5374	0.0026	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	19160	SERINGA DESC 20 ML UN	0.5400	0.5374	0.0026	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	31585	RANITIDINA 25 MG/ML 2 ML SI IV IM AP	0.9300	1.8676	-0.9376	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	31585	RANITIDINA 25 MG/ML 2 ML SI IV IM AP	0.9300	1.8668	-0.9368	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	31585	RANITIDINA 25 MG/ML 2 ML SI IV IM AP	0.9300	1.8668	-0.9368	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	31585	RANITIDINA 25 MG/ML 2 ML SI IV IM AP	0.9300	0.9334	-0.0034	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	31585	RANITIDINA 25 MG/ML 2 ML SI IV IM AP	0.9300	0.9334	-0.0034	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	31585	RANITIDINA 25 MG/ML 2 ML SI IV IM AP	0.9300	0.9334	-0.0034	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	19151	SERINGA DESC 10 ML UN	0.6634	0.9985	-0.6685	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	19151	SERINGA DESC 10 ML UN	0.6634	1.0003	-0.6703	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	19151	SERINGA DESC 10 ML UN	0.6634	1.0003	-0.6703	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	19151	SERINGA DESC 10 ML UN	0.6634	1.0003	-0.6703	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	19151	SERINGA DESC 10 ML UN	0.6634	1.0003	-0.6703	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	19151	SERINGA DESC 10 ML UN	0.3300	0.6669	-0.3369	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	19151	SERINGA DESC 10 ML UN	0.3300	0.6669	-0.3369	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	19151	SERINGA DESC 10 ML UN	0.3300	0.6669	-0.3369	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	19151	SERINGA DESC 10 ML UN	0.3300	0.6669	-0.3369	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	19151	SERINGA DESC 10 ML UN	0.3300	0.6669	-0.3369	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	19151	SERINGA DESC 10 ML UN	0.3300	0.6669	-0.3369	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	37761	ALCOOL ETILICO 70 % ST TP ML	0.0631	0.0695	-0.0395	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	21822	TRAMADOL 50 MG 1 ML SI IM IV AP	25.1571	29.3540	-25.1640	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	21822	TRAMADOL 50 MG 1 ML SI IM IV AP	25.1571	29.3540	-25.1640	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	11193	CLOREXIDINA 2 % ST TP ML	0.5300	0.5320	-0.0020	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	11193	CLOREXIDINA 2 % ST TP ML	0.5300	0.5320	-0.0020	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	05975	COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER	0.7739	0.8059	-0.7759	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	05975	COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER	0.7739	0.8059	-0.7759	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	05975	COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER	0.7739	0.8059	-0.7759	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	800720d33fe0defb6121e82dd216d044	JALMO	12786952647	NULL	12786952647	00124	LUVA CIRURGICA UN	0.0000	1.4500	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	800720d33fe0defb6121e82dd216d044	JALMO	12786952647	NULL	12786952647	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	800720d33fe0defb6121e82dd216d044	JALMO	12786952647	NULL	12786952647	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00171	SORO FISIOLOGICO 0,9% 250 ML SI IV BS	0.0000	3.9400	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00172	SORO FISIOLOGICO 0,9% 500 ML SI IV BS	0.0000	4.7300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	02246	HIDROCORTISONA 100 MG PO IM IV FA	0.0000	2.8300	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	02246	HIDROCORTISONA 100 MG PO IM IV FA	0.0000	2.8300	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	25030019	Distúrbios Circulatórios Artério - Venosos e Linfáticos	0.0000	80.2400	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	26981	SORO FISIOLOGICO 0,9% 10 ML SI IV AP	0.0000	0.0000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	26981	SORO FISIOLOGICO 0,9% 10 ML SI IV AP	0.0000	0.0000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	26981	SORO FISIOLOGICO 0,9% 10 ML SI IV AP	0.0000	0.0000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	26981	SORO FISIOLOGICO 0,9% 10 ML SI IV AP	0.0000	0.0000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	26981	SORO FISIOLOGICO 0,9% 10 ML SI IV AP	0.0000	0.9600	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00613	CLINDAMICINA 600 MG 4 ML SI IM IV AP	0.0000	13.0800	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00613	CLINDAMICINA 600 MG 4 ML SI IM IV AP	0.0000	13.0800	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00069	SERINGA DESC 10 ML UN	0.0000	0.0000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00069	SERINGA DESC 10 ML UN	0.0000	0.0000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	07802	PIPERACILINA 4 G + TAZOBACTAM 500 MG PO IV FA	0.0000	0.0000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00796	FLORATIL (SACCHAROMYCES BOULARDII) 200 MG PO VO	0.0000	4.4400	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	09071	ACETILCISTEINA 600MG PO VO SA	0.0000	3.4950	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	09071	ACETILCISTEINA 600MG PO VO SA	0.0000	3.4950	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00090	SERINGA DESC 20 ML UN	0.0000	0.0000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00124	LUVA CIRURGICA UN	0.0000	1.4475	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00124	LUVA CIRURGICA UN	0.0000	1.4475	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00124	LUVA CIRURGICA UN	0.0000	1.4475	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4062	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4062	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4062	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4062	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4062	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4062	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4062	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4062	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4062	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4062	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	01584	NEOSTIGMINA 0,5 MG/ML 1 ML SI IM IV SC AP	0.0000	0.7667	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	01584	NEOSTIGMINA 0,5 MG/ML 1 ML SI IM IV SC AP	0.0000	0.7667	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	01584	NEOSTIGMINA 0,5 MG/ML 1 ML SI IM IV SC AP	0.0000	0.7667	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	01584	NEOSTIGMINA 0,5 MG/ML 1 ML SI IM IV SC AP	0.0000	0.7667	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	01584	NEOSTIGMINA 0,5 MG/ML 1 ML SI IM IV SC AP	0.0000	0.7667	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	01584	NEOSTIGMINA 0,5 MG/ML 1 ML SI IM IV SC AP	0.0000	0.7667	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	24082	BROMOPRIDA 5 MG/ML 2 ML SI IM IV AP	0.0000	2.7300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00796	FLORATIL (SACCHAROMYCES BOULARDII) 200 MG PO VO	0.0000	4.4400	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00090	SERINGA DESC 20 ML UN	0.0000	0.5371	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00090	SERINGA DESC 20 ML UN	0.0000	0.5371	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00090	SERINGA DESC 20 ML UN	0.0000	0.5371	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00090	SERINGA DESC 20 ML UN	0.0000	0.5371	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00090	SERINGA DESC 20 ML UN	0.0000	0.5371	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00090	SERINGA DESC 20 ML UN	0.0000	0.5371	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00090	SERINGA DESC 20 ML UN	0.0000	0.5371	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00090	SERINGA DESC 20 ML UN	0.0000	0.5371	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00090	SERINGA DESC 20 ML UN	0.0000	0.5371	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00090	SERINGA DESC 20 ML UN	0.0000	0.5371	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00090	SERINGA DESC 20 ML UN	0.0000	0.5371	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4088	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4088	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4088	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4088	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1766	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1766	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1766	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1766	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1766	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00090	SERINGA DESC 20 ML UN	0.0000	0.5387	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00090	SERINGA DESC 20 ML UN	0.0000	0.5387	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00090	SERINGA DESC 20 ML UN	0.0000	0.5387	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00090	SERINGA DESC 20 ML UN	0.0000	0.5387	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00090	SERINGA DESC 20 ML UN	0.0000	0.5387	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00090	SERINGA DESC 20 ML UN	0.0000	0.5387	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00090	SERINGA DESC 20 ML UN	0.0000	0.5387	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00090	SERINGA DESC 20 ML UN	0.0000	0.5387	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00090	SERINGA DESC 20 ML UN	0.0000	0.5387	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00090	SERINGA DESC 20 ML UN	0.0000	0.5387	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00090	SERINGA DESC 20 ML UN	0.0000	0.5387	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00090	SERINGA DESC 20 ML UN	0.0000	0.5387	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00090	SERINGA DESC 20 ML UN	0.0000	0.5387	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	4c68006246c347121db1f06edf5e5051	MARIA	12734155245	NULL	12734155245	55050042	Mediastinoscopia e Biópsia	0.0000	0.0400	NULL	COBRANCA DE HONORARIOS EM DUPLICIDADE	2607
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12550571048	NULL	12550571048	00124	LUVA CIRURGICA UN	0.0000	1.4500	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12550571048	NULL	12550571048	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4074	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12550571048	NULL	12550571048	01611	CLORETO DE POTASSIO 600 MG CA VO UN	0.0000	0.4864	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12550571048	NULL	12550571048	01611	CLORETO DE POTASSIO 600 MG CA VO UN	0.0000	0.4867	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12550571048	NULL	12550571048	02246	HIDROCORTISONA 100 MG PO IM IV FA	0.0000	5.6697	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12550571048	NULL	12550571048	25040014	Fisioterapia Respiratória - em Doente Clínico Internado	0.0000	5.0300	NULL	EXAME NAO AUTORIZADO	2707
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12550571048	NULL	12550571048	29020166	Nebulização Simples com Broncodilatador	0.0000	1.1700	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12550571048	NULL	12550571048	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.0000	0.8100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12550571048	NULL	12550571048	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.0000	0.8089	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12550571048	NULL	12550571048	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1800	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12550571048	NULL	12550571048	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1775	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12550571048	NULL	12550571048	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1775	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12550571048	NULL	12550571048	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1775	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12550571048	NULL	12550571048	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1775	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12550571048	NULL	12550571048	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1775	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12550571048	NULL	12550571048	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1775	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12550571048	NULL	12550571048	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1775	NULL	VALOR APRESENTADO A MAIOR	1705
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12550571048	NULL	12550571048	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1775	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12550571048	NULL	12550571048	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1775	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12550571048	NULL	12550571048	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1800	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	9ffbbf7340bbd65e9e3baa9406d027f3	MARCO	12261811645	NULL	12261811645	00090	SERINGA DESC 20 ML UN	0.0000	0.5376	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	9ffbbf7340bbd65e9e3baa9406d027f3	MARCO	12261811645	NULL	12261811645	00090	SERINGA DESC 20 ML UN	0.0000	1.0752	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12579183644	NULL	12579183644	00124	LUVA CIRURGICA UN	0.0000	1.4476	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12579183644	NULL	12579183644	25040014	Fisioterapia Respiratória - em Doente Clínico Internado	0.0000	10.0600	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12579183644	NULL	12579183644	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12579183644	NULL	12579183644	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12579183644	NULL	12579183644	35382	COMPRESSAS DE GASES 7.5 X7,5 (11 FIOS ESTERIL) UN	0.0000	0.3000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12579183644	NULL	12579183644	51499	CAPTOPRIL 50 MG CP VO UN	0.0000	0.1352	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12579183644	NULL	12579183644	51584	ESPARADRAPO MICROPORE	0.0000	0.2600	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	00124	LUVA CIRURGICA UN	0.0000	1.4482	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	00124	LUVA CIRURGICA UN	0.0000	1.4482	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	00124	LUVA CIRURGICA UN	0.0000	1.4482	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	00124	LUVA CIRURGICA UN	0.0000	1.4500	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	00124	LUVA CIRURGICA UN	0.0000	1.4482	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	00124	LUVA CIRURGICA UN	0.0000	1.4482	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	00124	LUVA CIRURGICA UN	0.0000	1.4500	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	00124	LUVA CIRURGICA UN	0.0000	1.4500	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	00128	LUVA DE PROCEDIMENTO UNIDADE UN	0.0000	1.6700	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.0000	0.4000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1752	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1752	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1752	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1752	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1752	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	51241	AGULHA 123X45	0.0000	0.1900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	51241	AGULHA 123X45	0.0000	0.1900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	51241	AGULHA 123X45	0.0000	0.1900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	51241	AGULHA 123X45	0.0000	0.1900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	51241	AGULHA 123X45	0.0000	0.1900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	51590	ABAIXADOR DE LINGUA UN	0.0000	0.0500	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	51590	ABAIXADOR DE LINGUA UN	0.0000	0.0500	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	51590	ABAIXADOR DE LINGUA UN	0.0000	0.0500	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	51649	ALCOOL ETILICO 70 % ST TP ML	0.0000	0.0000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	52392	SONDA DE ASPIRAÇAO TRAQUEAL C/ VALVULA UN	0.0000	0.9352	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	52392	SONDA DE ASPIRAÇAO TRAQUEAL C/ VALVULA UN	0.0000	0.9352	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	52392	SONDA DE ASPIRAÇAO TRAQUEAL C/ VALVULA UN	0.0000	0.9352	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	52392	SONDA DE ASPIRAÇAO TRAQUEAL C/ VALVULA UN	0.0000	0.9352	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	52392	SONDA DE ASPIRAÇAO TRAQUEAL C/ VALVULA UN	0.0000	0.9352	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.0000	0.6874	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.0000	0.6874	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.0000	0.6874	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.0000	0.4000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1775	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.3500	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	53945	ACIDO ASCORBICO 500 MG CP VO UN	0.0000	0.5900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00128	LUVA DE PROCEDIMENTO UNIDADE UN	0.0000	1.6700	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	01496	FENITOINA 50 MG/ML 5 ML SI IM IV AP	0.0000	2.3400	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	01496	FENITOINA 50 MG/ML 5 ML SI IM IV AP	0.0000	2.3400	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	01584	NEOSTIGMINA 0,5 MG/ML 1 ML SI IM IV SC AP	0.0000	0.7662	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	24082	BROMOPRIDA 5 MG/ML 2 ML SI IM IV AP	0.0000	2.7300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	26981	SORO FISIOLOGICO 0,9% 10 ML SI IV AP	0.0000	0.9600	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	26981	SORO FISIOLOGICO 0,9% 10 ML SI IV AP	0.0000	0.9600	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	ea4ad2636c25d8e3dbb569ae62db71e7	IONE	12489788840	NULL	12489788840	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.0000	0.4000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	ea4ad2636c25d8e3dbb569ae62db71e7	IONE	12489788840	NULL	12489788840	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1800	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	ea4ad2636c25d8e3dbb569ae62db71e7	IONE	12489788840	NULL	12489788840	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1800	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	ea4ad2636c25d8e3dbb569ae62db71e7	IONE	12489788840	NULL	12489788840	00737	CEFTRIAXONA IV 1G + DIL. 10 ML PO IV FA	0.0000	27.0600	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	ea4ad2636c25d8e3dbb569ae62db71e7	IONE	12489788840	NULL	12489788840	00737	CEFTRIAXONA IV 1G + DIL. 10 ML PO IV FA	0.0000	27.0600	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	d17b3c5ae418d82694895a326dee545a	ODILIA	12670516743	NULL	12670516743	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	d17b3c5ae418d82694895a326dee545a	ODILIA	12670516743	NULL	12670516743	17252	LIDOCAINA 2% GE OU TP GR	0.0000	2.5900	NULL	OPME INVALIDO	2201
Glosa Min	2018-10-03 00:00:00.000000	1084117	d17b3c5ae418d82694895a326dee545a	ODILIA	12670516743	NULL	12670516743	17252	LIDOCAINA 2% GE OU TP GR	0.0000	2.5900	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	d17b3c5ae418d82694895a326dee545a	ODILIA	12670516743	NULL	12670516743	17252	LIDOCAINA 2% GE OU TP GR	0.0000	1.3000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	d17b3c5ae418d82694895a326dee545a	ODILIA	12670516743	NULL	12670516743	02197	METAMUCIL (PLANTAGO OVATA) 3,4 G PO VO EV	0.0000	2.4600	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	d17b3c5ae418d82694895a326dee545a	ODILIA	12670516743	NULL	12670516743	02197	METAMUCIL (PLANTAGO OVATA) 3,4 G PO VO EV	0.0000	2.4600	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	d17b3c5ae418d82694895a326dee545a	ODILIA	12670516743	NULL	12670516743	02197	METAMUCIL (PLANTAGO OVATA) 3,4 G PO VO EV	0.0000	2.4600	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	d17b3c5ae418d82694895a326dee545a	ODILIA	12670516743	NULL	12670516743	25040014	Fisioterapia Respiratória - em Doente Clínico Internado	0.0000	0.0000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	d17b3c5ae418d82694895a326dee545a	ODILIA	12670516743	NULL	12670516743	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	d17b3c5ae418d82694895a326dee545a	ODILIA	12670516743	NULL	12670516743	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	d17b3c5ae418d82694895a326dee545a	ODILIA	12670516743	NULL	12670516743	56261	CLOREXIDINA 2 % ST TP ML DEGERMANTE	0.0000	0.2650	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	d17b3c5ae418d82694895a326dee545a	ODILIA	12670516743	NULL	12670516743	56261	CLOREXIDINA 2 % ST TP ML DEGERMANTE	0.0000	0.2650	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1965b0cdebe9017c3397c8641147759	JOSE	12705413746	NULL	12705413746	102001	DIARIA DE APARTAMENTO	0.0000	288.8882	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1965b0cdebe9017c3397c8641147759	JOSE	12705413746	NULL	12705413746	102001	DIARIA DE APARTAMENTO	0.0000	288.8882	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1965b0cdebe9017c3397c8641147759	JOSE	12705413746	NULL	12705413746	102001	DIARIA DE APARTAMENTO	0.0000	288.8882	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1965b0cdebe9017c3397c8641147759	JOSE	12705413746	NULL	12705413746	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4074	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1965b0cdebe9017c3397c8641147759	JOSE	12705413746	NULL	12705413746	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4074	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1965b0cdebe9017c3397c8641147759	JOSE	12705413746	NULL	12705413746	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4074	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4072	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	02246	HIDROCORTISONA 100 MG PO IM IV FA	0.0000	2.8300	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	02246	HIDROCORTISONA 100 MG PO IM IV FA	0.0000	2.8300	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	26981	SORO FISIOLOGICO 0,9% 10 ML SI IV AP	0.0000	0.4800	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	26981	SORO FISIOLOGICO 0,9% 10 ML SI IV AP	0.0000	0.4800	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	00404	LACTULOSE 667 MG/ML XP VO ML	0.0000	6.4300	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	00404	LACTULOSE 667 MG/ML XP VO ML	0.0000	6.4300	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	00487	RANITIDINA 25 MG/ML 2 ML SI IM IV AP	0.0000	0.9300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.0000	0.4000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1769	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1771	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1771	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1771	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1771	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1771	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1771	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	081fdadb830fb547e83c43fabdb88372	ELZA	12377335349	NULL	12377335349	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1800	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	081fdadb830fb547e83c43fabdb88372	ELZA	12377335349	NULL	12377335349	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1800	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	081fdadb830fb547e83c43fabdb88372	ELZA	12377335349	NULL	12377335349	00097	ABOCATH N 14 A 22 UN	0.0000	3.7700	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	081fdadb830fb547e83c43fabdb88372	ELZA	12377335349	NULL	12377335349	00098	ABOCATH N 14 A 22 UN	0.0000	3.7700	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	24571	CLINDAMICINA 600 MG 4 ML SI IM IV AP	0.0000	13.0800	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	24571	CLINDAMICINA 600 MG 4 ML SI IM IV AP	0.0000	13.0800	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	24571	CLINDAMICINA 600 MG 4 ML SI IM IV AP	0.0000	13.0800	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	24571	CLINDAMICINA 600 MG 4 ML SI IM IV AP	0.0000	13.0800	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	dd486d36a88cfef0b44fe652638a0164	DELFINA	12660326244	NULL	12660326244	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	dd486d36a88cfef0b44fe652638a0164	DELFINA	12660326244	NULL	12660326244	00406	FUROSEMIDA 10 MG/ML 2 ML SI IM IV AP	0.0000	0.6000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	dd486d36a88cfef0b44fe652638a0164	DELFINA	12660326244	NULL	12660326244	00406	FUROSEMIDA 10 MG/ML 2 ML SI IM IV AP	0.0000	0.6000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	dd486d36a88cfef0b44fe652638a0164	DELFINA	12660326244	NULL	12660326244	00406	FUROSEMIDA 10 MG/ML 2 ML SI IM IV AP	0.0000	0.6000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	dd486d36a88cfef0b44fe652638a0164	DELFINA	12660326244	NULL	12660326244	00406	FUROSEMIDA 10 MG/ML 2 ML SI IM IV AP	0.0000	1.2000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	dd486d36a88cfef0b44fe652638a0164	DELFINA	12660326244	NULL	12660326244	44001	BOLSA COLETORA (SISTEMA ABERTO) UN	0.0000	0.3200	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	dd486d36a88cfef0b44fe652638a0164	DELFINA	12660326244	NULL	12660326244	00487	RANITIDINA 25 MG/ML 2 ML SI IM IV AP	0.0000	0.9300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	dd486d36a88cfef0b44fe652638a0164	DELFINA	12660326244	NULL	12660326244	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.0000	0.8100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	dd486d36a88cfef0b44fe652638a0164	DELFINA	12660326244	NULL	12660326244	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.0000	0.8100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	dd486d36a88cfef0b44fe652638a0164	DELFINA	12660326244	NULL	12660326244	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.0000	0.8100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	dd486d36a88cfef0b44fe652638a0164	DELFINA	12660326244	NULL	12660326244	51379	SERINGA DESC 05 ML UN	0.0000	0.1900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	dd486d36a88cfef0b44fe652638a0164	DELFINA	12660326244	NULL	12660326244	51379	SERINGA DESC 05 ML UN	0.0000	0.1900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	dd486d36a88cfef0b44fe652638a0164	DELFINA	12660326244	NULL	12660326244	51497	ESPIRONOLACTONA 50 MG + HIDROCLOROTIAZIDA 50 MG	0.0000	0.9800	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	dd486d36a88cfef0b44fe652638a0164	DELFINA	12660326244	NULL	12660326244	51497	ESPIRONOLACTONA 50 MG + HIDROCLOROTIAZIDA 50 MG	0.0000	0.9800	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	dd486d36a88cfef0b44fe652638a0164	DELFINA	12660326244	NULL	12660326244	00541	AMIODARONA 200 MG CP VO UN	0.0000	0.8400	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	dd486d36a88cfef0b44fe652638a0164	DELFINA	12660326244	NULL	12660326244	00541	AMIODARONA 200 MG CP VO UN	0.0000	0.8400	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	dd486d36a88cfef0b44fe652638a0164	DELFINA	12660326244	NULL	12660326244	00541	AMIODARONA 200 MG CP VO UN	0.0000	0.8400	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	dd486d36a88cfef0b44fe652638a0164	DELFINA	12660326244	NULL	12660326244	06400	CARVEDILOL 3,125 MG CP VO UN	0.0000	0.7300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	dd486d36a88cfef0b44fe652638a0164	DELFINA	12660326244	NULL	12660326244	06400	CARVEDILOL 3,125 MG CP VO UN	0.0000	0.7300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	102001	DIARIA DE APARTAMENTO	0.0000	288.8900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	11325	EQUIPO MACRO-GOTAS FLEXIVEL C/ INJETOR LATERAL UN	0.0000	1.5900	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	51589	ESPARADRAPO 10 X 4.5 CM CM	0.0000	0.4000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	51649	ALCOOL ETILICO 70 % ST TP ML	0.0000	0.0300	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	00090	SERINGA DESC 20 ML UN	0.0000	0.5400	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	00919	ALGODAO HIDROFILO BOLINHA UN	0.0000	0.2600	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	f3ad474c8c562757c4d1a959ff0961c4	DJALMA	12718763240	NULL	12718763240	00037	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	f3ad474c8c562757c4d1a959ff0961c4	DJALMA	12718763240	NULL	12718763240	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1800	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	f3ad474c8c562757c4d1a959ff0961c4	DJALMA	12718763240	NULL	12718763240	51584	ESPARADRAPO MICROPORE	0.0000	0.7700	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	f3ad474c8c562757c4d1a959ff0961c4	DJALMA	12718763240	NULL	12718763240	51588	ESPARADRAPO MICROPORE 50 X 10 CM CM	0.0000	0.7700	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	f3ad474c8c562757c4d1a959ff0961c4	DJALMA	12718763240	NULL	12718763240	00090	SERINGA DESC 20 ML UN	0.0000	0.5400	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	806bfa8e76209648a4ae145ff436d092	GILBERTO	12692620640	NULL	12692620640	20010010	Eletrocardiograma - Ecg	0.0000	0.1200	NULL	EXAME SEM REGISTRO DE EXECUCAO	2703
Glosa Min	2018-10-03 00:00:00.000000	1084117	806bfa8e76209648a4ae145ff436d092	GILBERTO	12692620640	NULL	12692620640	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.0000	0.6875	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	806bfa8e76209648a4ae145ff436d092	GILBERTO	12692620640	NULL	12692620640	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.0000	0.6875	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	806bfa8e76209648a4ae145ff436d092	GILBERTO	12692620640	NULL	12692620640	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.0000	0.6875	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3fb5c891f31bb9efcb05395066127c52	ALAIDE	12636273441	NULL	12636273441	14250	PARACETAMOL 750 MG CP VO UN	0.0000	0.0000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3fb5c891f31bb9efcb05395066127c52	ALAIDE	12636273441	NULL	12636273441	14250	PARACETAMOL 750 MG CP VO UN	0.0000	0.4500	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00090	SERINGA DESC 20 ML UN	0.5400	0.2200	0.3200	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00090	SERINGA DESC 20 ML UN	0.5400	0.2200	0.3200	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.6900	0.2700	0.4200	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.6900	0.2700	0.4200	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.6900	0.2700	0.4200	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.6900	0.2700	0.4200	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.6900	0.2700	0.4200	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.6900	0.2700	0.4200	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.6900	0.2700	0.4200	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.6900	0.2700	0.4200	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00493	BROMOPRIDA 5 MG/ML 2 ML SI IM IV AP	2.7300	1.0600	1.6700	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00493	BROMOPRIDA 5 MG/ML 2 ML SI IM IV AP	2.7300	1.0600	1.6700	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	53144	TRAMAL	5.9900	2.3300	3.6600	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	25030019	Distúrbios Circulatórios Artério - Venosos e Linfáticos	11.4600	4.4700	6.9900	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	16b1e9f62f247f02ad5cac910ee15b4e	BERCHOLINA	12631612848	NULL	12631612848	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4081	0.0019	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	16b1e9f62f247f02ad5cac910ee15b4e	BERCHOLINA	12631612848	NULL	12631612848	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4081	0.0019	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	16b1e9f62f247f02ad5cac910ee15b4e	BERCHOLINA	12631612848	NULL	12631612848	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4081	0.0019	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	16b1e9f62f247f02ad5cac910ee15b4e	BERCHOLINA	12631612848	NULL	12631612848	19160	SERINGA DESC 20 ML UN	0.5400	0.5386	0.0014	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	16b1e9f62f247f02ad5cac910ee15b4e	BERCHOLINA	12631612848	NULL	12631612848	33219	LUVA DE PROCEDIMENTO UNIDADE UN	0.8370	1.0018	-0.3318	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	16b1e9f62f247f02ad5cac910ee15b4e	BERCHOLINA	12631612848	NULL	12631612848	00171	SORO FISIOLOGICO 0,9% 250 ML SI IV BS	3.9400	3.7600	0.1800	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	01081195	eb2a9408781bd23e7832b0d68b2d112e	KAROLAYNE	12750768110	NULL	12750768110	00010014	CONSULTA EM CONSULTORIO MEDICO	0.0000	0.0000	50.0000	GUIA DE CONSULTA NAO EXECUTADA	0622
Glosa Min	2018-10-03 00:00:00.000000	1084117	dd6f8d6c53ffe9bfd3aa9590ba500cc8	ILDA	12751932542	NULL	12751932542	05975	COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER	1.2000	0.3800	0.8200	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12550571048	NULL	12550571048	05975	COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER	0.3000	0.1500	0.1500	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12550571048	NULL	12550571048	53660	EQUIPO MACRO-GOTAS FLEXIVEL C/ INJETOR LATE	1.5900	0.0000	1.5900	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12550571048	NULL	12550571048	08648	ESPARADRAPO 10 X 4.5 CM CM	0.4000	0.2000	0.2000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12550571048	NULL	12550571048	33219	LUVA DE PROCEDIMENTO UNIDADE UN	1.6700	0.6700	1.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	57495	FILTRO BARREIRA E REGENERADOR DE CALOR E UM	24.0000	0.0000	24.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	28959	DERSANI LC TP ML	29.1000	9.7000	19.4000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	27316	EQUIPO P/ DIETA ENTERAL UN	1.7000	0.0000	1.7000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	37761	ALCOOL ETILICO 70 % ST TP ML	0.0300	0.0000	0.0300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	75bcd473a0dc7c7a6751499b38a4a034	JOAQUIM	12692852143	NULL	12692852143	00817	ALGODAO HIDROFILO BOLINHA UN	0.2600	0.1300	0.1300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	75bcd473a0dc7c7a6751499b38a4a034	JOAQUIM	12692852143	NULL	12692852143	00817	ALGODAO HIDROFILO BOLINHA UN	0.2600	0.1300	0.1300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	4668d2494ed6c4b2d18be299efcb26a2	JOAO	12469689344	NULL	12469689344	11193	CLOREXIDINA 2 % ST TP ML	0.5300	0.2700	0.2600	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	22756	LIDOCAINA 2% S/ VASO SI PE ML	0.2300	0.0000	0.2300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	0.0000	3.4100	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	14370	FIO MONONYLON 3-0 C/ AGULHA 2,4 3/8 163T E	6.6900	0.0000	6.6900	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	22756	LIDOCAINA 2% S/ VASO SI PE ML	0.9400	0.0000	0.9400	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12603877940	NULL	12603877940	33219	LUVA DE PROCEDIMENTO UNIDADE UN	1.6700	0.0000	1.6700	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12603877940	NULL	12603877940	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.0000	0.1000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	33219	LUVA DE PROCEDIMENTO UNIDADE UN	1.0000	0.6700	0.3300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	00817	ALGODAO HIDROFILO BOLINHA UN	0.2600	0.1300	0.1300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	33219	LUVA DE PROCEDIMENTO UNIDADE UN	1.0000	0.6700	0.3300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	37761	ALCOOL ETILICO 70 % ST TP ML	0.0300	0.0200	0.0100	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	08648	ESPARADRAPO 10 X 4.5 CM CM	0.4000	0.0000	0.4000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	28959	DERSANI LC TP ML	19.4000	9.7000	9.7000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	11193	CLOREXIDINA 2 % ST TP ML	0.5300	0.2700	0.2600	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00817	ALGODAO HIDROFILO BOLINHA UN	0.2600	0.1300	0.1300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	28959	DERSANI LC TP ML	19.4000	9.7000	9.7000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	32891	EQUIPO POLIFIX 2ş VIAS UN	2.5500	0.0000	2.5500	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1965b0cdebe9017c3397c8641147759	JOSE	12705413746	NULL	12705413746	20559	SORO FISIOLOGICO 0,9% 250 ML SI IV BS	3.9400	0.0000	3.9400	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12558131243	NULL	12558131243	37761	ALCOOL ETILICO 70 % ST TP ML	0.0600	0.0300	0.0300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12558131243	NULL	12558131243	08664	ESPARADRAPO MICROPORE 50 X 10 CM CM	0.7700	0.2600	0.5100	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	37761	ALCOOL ETILICO 70 % ST TP ML	0.0300	0.0200	0.0100	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	7c2bc8cd9bbf9ce081562a3c63fff8c9	MARTA	12647505849	NULL	12647505849	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1756	0.0044	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	f65f553befc0e3bc8bd5bce5c1c6e413	NAIRLENE	12633078944	NULL	12633078944	33219	LUVA DE PROCEDIMENTO UNIDADE UN	1.6700	1.6650	0.0050	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	f65f553befc0e3bc8bd5bce5c1c6e413	NAIRLENE	12633078944	NULL	12633078944	19160	SERINGA DESC 20 ML UN	0.5400	0.5367	0.0033	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	f65f553befc0e3bc8bd5bce5c1c6e413	NAIRLENE	12633078944	NULL	12633078944	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4067	0.0033	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	f65f553befc0e3bc8bd5bce5c1c6e413	NAIRLENE	12633078944	NULL	12633078944	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4067	0.0033	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	f65f553befc0e3bc8bd5bce5c1c6e413	NAIRLENE	12633078944	NULL	12633078944	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4067	0.0033	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	f65f553befc0e3bc8bd5bce5c1c6e413	NAIRLENE	12633078944	NULL	12633078944	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1760	0.0040	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	f65f553befc0e3bc8bd5bce5c1c6e413	NAIRLENE	12633078944	NULL	12633078944	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1760	0.0040	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	f65f553befc0e3bc8bd5bce5c1c6e413	NAIRLENE	12633078944	NULL	12633078944	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1760	0.0040	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	f65f553befc0e3bc8bd5bce5c1c6e413	NAIRLENE	12633078944	NULL	12633078944	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1760	0.0040	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	c2bcdc3cbedb73a0db271ac09d4587a1	ORDETE	12694018147	NULL	12694018147	08664	ESPARADRAPO MICROPORE 50 X 10 CM CM	0.7700	0.7600	0.0000	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	c2bcdc3cbedb73a0db271ac09d4587a1	ORDETE	12694018147	NULL	12694018147	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1760	0.0040	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	f93cee6f501560245a8f94ffc5c6c246	ROSEDALIA	12622895145	NULL	12622895145	19160	SERINGA DESC 20 ML UN	0.5400	0.5373	0.0027	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	f93cee6f501560245a8f94ffc5c6c246	ROSEDALIA	12622895145	NULL	12622895145	19160	SERINGA DESC 20 ML UN	0.5400	0.5373	0.0027	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	f93cee6f501560245a8f94ffc5c6c246	ROSEDALIA	12622895145	NULL	12622895145	19160	SERINGA DESC 20 ML UN	0.5400	0.5373	0.0027	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	d4089ccef13567fd45b16fb0b60685fa	VERA	12640482546	NULL	12640482546	27480	CLARITROMICINA 500 MG 30 ML PO IV FA	117.1100	117.1050	0.0050	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	d4089ccef13567fd45b16fb0b60685fa	VERA	12640482546	NULL	12640482546	27480	CLARITROMICINA 500 MG 30 ML PO IV FA	117.1100	117.1050	0.0050	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	d4089ccef13567fd45b16fb0b60685fa	VERA	12640482546	NULL	12640482546	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1754	0.0046	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	d4089ccef13567fd45b16fb0b60685fa	VERA	12640482546	NULL	12640482546	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1754	0.0046	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	d4089ccef13567fd45b16fb0b60685fa	VERA	12640482546	NULL	12640482546	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1754	0.0046	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	eecb3d883747b059c3fe231c34567476	AFFRIDES	12693180144	NULL	12693180144	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4074	0.0026	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	eecb3d883747b059c3fe231c34567476	AFFRIDES	12693180144	NULL	12693180144	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4074	0.0026	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	eecb3d883747b059c3fe231c34567476	AFFRIDES	12693180144	NULL	12693180144	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4074	0.0026	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	eecb3d883747b059c3fe231c34567476	AFFRIDES	12693180144	NULL	12693180144	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4074	0.0026	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	eecb3d883747b059c3fe231c34567476	AFFRIDES	12693180144	NULL	12693180144	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4074	0.0026	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	eecb3d883747b059c3fe231c34567476	AFFRIDES	12693180144	NULL	12693180144	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4074	0.0026	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	eecb3d883747b059c3fe231c34567476	AFFRIDES	12693180144	NULL	12693180144	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	6.8200	6.8149	0.0051	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	eecb3d883747b059c3fe231c34567476	AFFRIDES	12693180144	NULL	12693180144	19160	SERINGA DESC 20 ML UN	0.5400	0.5368	0.0032	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	eecb3d883747b059c3fe231c34567476	AFFRIDES	12693180144	NULL	12693180144	19160	SERINGA DESC 20 ML UN	0.5400	0.5372	0.0028	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	eecb3d883747b059c3fe231c34567476	AFFRIDES	12693180144	NULL	12693180144	19160	SERINGA DESC 20 ML UN	0.5400	0.5372	0.0028	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	eecb3d883747b059c3fe231c34567476	AFFRIDES	12693180144	NULL	12693180144	19160	SERINGA DESC 20 ML UN	0.5400	0.5372	0.0028	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	eecb3d883747b059c3fe231c34567476	AFFRIDES	12693180144	NULL	12693180144	19160	SERINGA DESC 20 ML UN	0.5400	0.5372	0.0028	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1d6bbb4a00130e2e654e830fc9bae6a	ALEXANDRINA	12694224940	NULL	12694224940	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1700	0.0000	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1d6bbb4a00130e2e654e830fc9bae6a	ALEXANDRINA	12694224940	NULL	12694224940	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4072	0.0028	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1d6bbb4a00130e2e654e830fc9bae6a	ALEXANDRINA	12694224940	NULL	12694224940	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4072	0.0028	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1d6bbb4a00130e2e654e830fc9bae6a	ALEXANDRINA	12694224940	NULL	12694224940	19160	SERINGA DESC 20 ML UN	0.5400	0.5367	0.0033	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1d6bbb4a00130e2e654e830fc9bae6a	ALEXANDRINA	12694224940	NULL	12694224940	19160	SERINGA DESC 20 ML UN	0.5400	0.5367	0.0033	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1d6bbb4a00130e2e654e830fc9bae6a	ALEXANDRINA	12694224940	NULL	12694224940	19160	SERINGA DESC 20 ML UN	0.5400	0.5367	0.0033	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1d6bbb4a00130e2e654e830fc9bae6a	ALEXANDRINA	12694224940	NULL	12694224940	19160	SERINGA DESC 20 ML UN	0.5400	0.5367	0.0033	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1d6bbb4a00130e2e654e830fc9bae6a	ALEXANDRINA	12694224940	NULL	12694224940	19160	SERINGA DESC 20 ML UN	0.5400	0.5367	0.0033	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1d6bbb4a00130e2e654e830fc9bae6a	ALEXANDRINA	12694224940	NULL	12694224940	19160	SERINGA DESC 20 ML UN	0.5400	0.5367	0.0033	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	345c226bfea274af1372d41b0305a6c8	ALTINO	12720257940	NULL	12720257940	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.1000	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	345c226bfea274af1372d41b0305a6c8	ALTINO	12720257940	NULL	12720257940	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.1000	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.1038	-0.0038	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.1038	-0.0038	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.1038	-0.0038	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.1038	-0.0038	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.1038	-0.0038	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	19160	SERINGA DESC 20 ML UN	0.5400	0.5378	0.0022	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	19160	SERINGA DESC 20 ML UN	0.5400	0.5378	0.0022	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	19160	SERINGA DESC 20 ML UN	0.5400	0.5378	0.0022	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1797	0.0003	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1797	0.0003	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1797	0.0003	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1797	0.0003	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1900	0.1797	0.0103	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	e3731e8ac87e0066ebac4c8795b1893e	FRANCISCA	12607435740	NULL	12607435740	20567	SORO FISIOLOGICO 0,9% 500 ML SI IV BS	4.7300	4.7350	-0.0050	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12550571048	NULL	12550571048	05975	COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER	0.3000	0.0000	0.3000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12550571048	NULL	12550571048	08648	ESPARADRAPO 10 X 4.5 CM CM	0.4000	0.0000	0.4000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12550571048	NULL	12550571048	05975	COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER	0.3000	0.0000	0.3000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12550571048	NULL	12550571048	05975	COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER	0.3000	0.0000	0.3000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12550571048	NULL	12550571048	05975	COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER	0.3000	0.0000	0.3000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	b288bbcfb9aecab51bcb0dba62ca0059	IVONETE	12743730847	NULL	12743730847	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4063	0.0037	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	20cbe2e07b1dcd2b6af609a50df7ae80	LUCELENA	12690767849	NULL	12690767849	19496	METILPREDNISOLONA (SUCCINATO SODICO) 125 MG	30.5600	30.5500	0.0000	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	20cbe2e07b1dcd2b6af609a50df7ae80	LUCELENA	12690767849	NULL	12690767849	32891	EQUIPO POLIFIX 2ş VIAS UN	2.5500	0.0000	2.5500	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	20cbe2e07b1dcd2b6af609a50df7ae80	LUCELENA	12690767849	NULL	12690767849	27480	CLARITROMICINA 500 MG 30 ML PO IV FA	117.1100	117.1050	0.0050	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	20cbe2e07b1dcd2b6af609a50df7ae80	LUCELENA	12690767849	NULL	12690767849	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1758	0.0042	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	20cbe2e07b1dcd2b6af609a50df7ae80	LUCELENA	12690767849	NULL	12690767849	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1758	0.0042	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	20cbe2e07b1dcd2b6af609a50df7ae80	LUCELENA	12690767849	NULL	12690767849	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1758	0.0042	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	20cbe2e07b1dcd2b6af609a50df7ae80	LUCELENA	12690767849	NULL	12690767849	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1758	0.0042	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	20cbe2e07b1dcd2b6af609a50df7ae80	LUCELENA	12690767849	NULL	12690767849	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1758	0.0042	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	20cbe2e07b1dcd2b6af609a50df7ae80	LUCELENA	12690767849	NULL	12690767849	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1758	0.0042	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	20cbe2e07b1dcd2b6af609a50df7ae80	LUCELENA	12690767849	NULL	12690767849	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4084	0.0016	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	20cbe2e07b1dcd2b6af609a50df7ae80	LUCELENA	12690767849	NULL	12690767849	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4084	0.0016	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	20cbe2e07b1dcd2b6af609a50df7ae80	LUCELENA	12690767849	NULL	12690767849	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4084	0.0016	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	20cbe2e07b1dcd2b6af609a50df7ae80	LUCELENA	12690767849	NULL	12690767849	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4084	0.0016	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	20cbe2e07b1dcd2b6af609a50df7ae80	LUCELENA	12690767849	NULL	12690767849	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4084	0.0016	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	20cbe2e07b1dcd2b6af609a50df7ae80	LUCELENA	12690767849	NULL	12690767849	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4084	0.0016	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	20cbe2e07b1dcd2b6af609a50df7ae80	LUCELENA	12690767849	NULL	12690767849	19160	SERINGA DESC 20 ML UN	0.5400	0.5372	0.0028	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	20cbe2e07b1dcd2b6af609a50df7ae80	LUCELENA	12690767849	NULL	12690767849	19160	SERINGA DESC 20 ML UN	0.5400	0.5384	0.0016	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	20cbe2e07b1dcd2b6af609a50df7ae80	LUCELENA	12690767849	NULL	12690767849	19160	SERINGA DESC 20 ML UN	0.5400	0.5384	0.0016	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	20cbe2e07b1dcd2b6af609a50df7ae80	LUCELENA	12690767849	NULL	12690767849	19160	SERINGA DESC 20 ML UN	0.5400	0.5384	0.0016	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	20cbe2e07b1dcd2b6af609a50df7ae80	LUCELENA	12690767849	NULL	12690767849	19160	SERINGA DESC 20 ML UN	0.5400	0.5384	0.0016	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	32204	CLORETO DE SODIO 0,9% 10 ML SI IV AP	0.9600	0.0000	0.9600	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	19445	CLORETO DE POTASSIO 600 MG CA VO UN	0.4900	0.4867	0.0033	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	19445	CLORETO DE POTASSIO 600 MG CA VO UN	0.4900	0.4867	0.0033	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4075	0.0025	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4075	0.0025	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4075	0.0025	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4075	0.0025	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4075	0.0025	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4075	0.0025	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	07269	DIPIRONA 500 MG/ML 2 ML SI IV IM AP	0.6900	0.6883	0.0017	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	07269	DIPIRONA 500 MG/ML 2 ML SI IV IM AP	0.6900	0.6865	0.0035	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	07269	DIPIRONA 500 MG/ML 2 ML SI IV IM AP	0.6900	0.6865	0.0035	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	07269	DIPIRONA 500 MG/ML 2 ML SI IV IM AP	0.6900	0.6865	0.0035	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	07269	DIPIRONA 500 MG/ML 2 ML SI IV IM AP	0.6900	0.6865	0.0035	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	07269	DIPIRONA 500 MG/ML 2 ML SI IV IM AP	0.6900	0.6865	0.0035	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	19160	SERINGA DESC 20 ML UN	0.5400	0.5375	0.0025	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	19160	SERINGA DESC 20 ML UN	0.5400	0.5375	0.0025	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1769	0.0031	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1769	0.0031	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00426	AGUA BIDESTILADA 10 ML SI IV IM AP	0.8100	0.8073	0.0027	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00426	AGUA BIDESTILADA 10 ML SI IV IM AP	0.8100	0.8073	0.0027	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	19160	SERINGA DESC 20 ML UN	0.5400	0.5372	0.0028	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	19160	SERINGA DESC 20 ML UN	0.5400	0.5372	0.0028	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	19160	SERINGA DESC 20 ML UN	0.5400	0.5372	0.0028	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	19160	SERINGA DESC 20 ML UN	0.5400	0.5372	0.0028	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1779	0.0021	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1779	0.0021	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	08664	ESPARADRAPO MICROPORE 50 X 10 CM CM	0.2600	0.2558	0.0042	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	08664	ESPARADRAPO MICROPORE 50 X 10 CM CM	0.2600	0.2558	0.0042	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	08664	ESPARADRAPO MICROPORE 50 X 10 CM CM	0.2600	0.2558	0.0042	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	08664	ESPARADRAPO MICROPORE 50 X 10 CM CM	0.2600	0.2558	0.0042	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	e2b254ce765be196b019032789d8f852	MARIA	12576216044	NULL	12576216044	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4078	0.0022	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	32891	EQUIPO POLIFIX 2ş VIAS UN	2.5500	0.0000	2.5500	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	32891	EQUIPO POLIFIX 2ş VIAS UN	2.5500	2.5500	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	32891	EQUIPO POLIFIX 2ş VIAS UN	2.5500	0.0000	2.5500	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	d17b3c5ae418d82694895a326dee545a	ODILIA	12670516743	NULL	12670516743	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1774	0.0026	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	d17b3c5ae418d82694895a326dee545a	ODILIA	12670516743	NULL	12670516743	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1774	0.0026	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	d17b3c5ae418d82694895a326dee545a	ODILIA	12670516743	NULL	12670516743	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1774	0.0026	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	6ccea6ac8c216c032723aee73a9f81c9	PRISCILA	12662249242	NULL	12662249242	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4067	0.0033	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	6ccea6ac8c216c032723aee73a9f81c9	PRISCILA	12662249242	NULL	12662249242	07269	DIPIRONA 500 MG/ML 2 ML SI IV IM AP	0.6900	0.6864	0.0036	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	6ccea6ac8c216c032723aee73a9f81c9	PRISCILA	12662249242	NULL	12662249242	07269	DIPIRONA 500 MG/ML 2 ML SI IV IM AP	0.6900	0.6864	0.0036	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	6ccea6ac8c216c032723aee73a9f81c9	PRISCILA	12662249242	NULL	12662249242	07269	DIPIRONA 500 MG/ML 2 ML SI IV IM AP	0.6900	0.6864	0.0036	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.1000	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.1000	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.1000	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.1000	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.1000	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.1000	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.1000	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.1000	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.1000	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.1000	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.1000	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00426	AGUA BIDESTILADA 10 ML SI IV IM AP	0.8100	0.0000	0.8100	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	33227	LUVA CIRURGICA PAR UN	1.4500	1.4476	0.0024	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	19151	SERINGA DESC 10 ML UN	0.3300	0.3333	-0.0033	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	19160	SERINGA DESC 20 ML UN	0.5400	0.5384	0.0016	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	19160	SERINGA DESC 20 ML UN	0.5400	0.5384	0.0016	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	32891	EQUIPO POLIFIX 2ş VIAS UN	2.5500	2.5500	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1776	0.0024	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1776	0.0024	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1776	0.0024	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1776	0.0024	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	00426	AGUA BIDESTILADA 10 ML SI IV IM AP	0.8100	0.8092	0.0008	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	00426	AGUA BIDESTILADA 10 ML SI IV IM AP	0.8100	0.8092	0.0008	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	11193	CLOREXIDINA 2 % ST TP ML	0.5300	0.5300	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	0111beed375944f60c7ad4a7fd4874f8	WALDIR	12746025744	NULL	12746025744	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1773	0.0027	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	0111beed375944f60c7ad4a7fd4874f8	WALDIR	12746025744	NULL	12746025744	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1773	0.0027	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	0111beed375944f60c7ad4a7fd4874f8	WALDIR	12746025744	NULL	12746025744	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1773	0.0027	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	0111beed375944f60c7ad4a7fd4874f8	WALDIR	12746025744	NULL	12746025744	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1773	0.0027	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	0111beed375944f60c7ad4a7fd4874f8	WALDIR	12746025744	NULL	12746025744	00426	AGUA BIDESTILADA 10 ML SI IV IM AP	0.8100	0.8074	0.0026	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	05975	COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER	0.3000	0.0000	0.3000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00426	AGUA BIDESTILADA 10 ML SI IV IM AP	0.8100	0.8079	0.0021	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00426	AGUA BIDESTILADA 10 ML SI IV IM AP	0.8100	0.8079	0.0021	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00426	AGUA BIDESTILADA 10 ML SI IV IM AP	0.8100	0.8079	0.0021	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	08435	EQUIPO P/ BOMBA DE INFUSAO ENTERAL / PARENT	20.2800	20.2775	0.0025	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	75bcd473a0dc7c7a6751499b38a4a034	JOAQUIM	12692852143	NULL	12692852143	37761	ALCOOL ETILICO 70 % ST TP ML	0.0300	0.0000	0.0300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	75bcd473a0dc7c7a6751499b38a4a034	JOAQUIM	12692852143	NULL	12692852143	53660	EQUIPO MACRO-GOTAS FLEXIVEL C/ INJETOR LATE	1.5900	1.5900	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	610c198ec4c064687cf0524f147d3aed	ROBERTO	12748814743	NULL	12748814743	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1767	0.0033	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	610c198ec4c064687cf0524f147d3aed	ROBERTO	12748814743	NULL	12748814743	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1767	0.0033	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	610c198ec4c064687cf0524f147d3aed	ROBERTO	12748814743	NULL	12748814743	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4083	0.0017	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	610c198ec4c064687cf0524f147d3aed	ROBERTO	12748814743	NULL	12748814743	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4083	0.0017	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12647284040	NULL	12647284040	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4080	0.0020	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12647284040	NULL	12647284040	00590	AGULHA DESC 30 X 7 - 40X12 UN	0.1800	0.1750	0.0050	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12647284040	NULL	12647284040	08664	ESPARADRAPO MICROPORE 50 X 10 CM CM	0.7700	0.7667	0.0033	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12647284040	NULL	12647284040	20567	SORO FISIOLOGICO 0,9% 500 ML SI IV BS	9.4700	9.4697	0.0003	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12647284040	NULL	12647284040	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4086	0.0014	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12647284040	NULL	12647284040	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4086	0.0014	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12647284040	NULL	12647284040	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4086	0.0014	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12647284040	NULL	12647284040	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4086	0.0014	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12647284040	NULL	12647284040	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4086	0.0014	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12647284040	NULL	12647284040	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4086	0.0014	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	11193	CLOREXIDINA 2 % ST TP ML	0.5300	0.0000	0.5300	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	33545	PIPERACILINA 4 G + TAZOBACTAM 500 MG PO IV	83.4500	83.4500	0.0000	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	6.8156	-3.4056	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	6.8145	-3.4045	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	6.8145	-3.4045	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	6.8145	-3.4045	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	6.8145	-3.4045	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	6.8145	-3.4045	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4072	0.0028	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	57835	SORO FISIOLOGICO 0,9% 100 ML SI IV BS	3.4100	3.4072	0.0028	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.2120	-0.1120	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.2120	-0.1120	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.2120	-0.1120	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.2120	-0.1120	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00558	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.1000	0.2120	-0.1120	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	19160	SERINGA DESC 20 ML UN	0.5400	0.5374	0.0026	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	19160	SERINGA DESC 20 ML UN	0.5400	0.5374	0.0026	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	19160	SERINGA DESC 20 ML UN	0.5400	0.5374	0.0026	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	19160	SERINGA DESC 20 ML UN	0.5400	0.5374	0.0026	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	19160	SERINGA DESC 20 ML UN	0.5400	0.5374	0.0026	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	19160	SERINGA DESC 20 ML UN	0.5400	0.5374	0.0026	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	19160	SERINGA DESC 20 ML UN	0.5400	0.5374	0.0026	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	19160	SERINGA DESC 20 ML UN	0.5400	0.5374	0.0026	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	19160	SERINGA DESC 20 ML UN	0.5400	0.5374	0.0026	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	19160	SERINGA DESC 20 ML UN	0.5400	0.5374	0.0026	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00426	AGUA BIDESTILADA 10 ML SI IV IM AP	0.4000	0.4037	-0.0037	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00426	AGUA BIDESTILADA 10 ML SI IV IM AP	0.4000	0.4037	-0.0037	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00426	AGUA BIDESTILADA 10 ML SI IV IM AP	0.8100	0.8073	0.0027	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00426	AGUA BIDESTILADA 10 ML SI IV IM AP	0.8100	0.8073	0.0027	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00426	AGUA BIDESTILADA 10 ML SI IV IM AP	0.8100	0.8073	0.0027	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00426	AGUA BIDESTILADA 10 ML SI IV IM AP	0.8100	0.8073	0.0027	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00426	AGUA BIDESTILADA 10 ML SI IV IM AP	0.8100	0.8073	0.0027	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00426	AGUA BIDESTILADA 10 ML SI IV IM AP	0.8100	0.8073	0.0027	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	33219	LUVA DE PROCEDIMENTO UNIDADE UN	1.0000	1.0050	-0.0050	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	09636	FLORATIL (SACCHAROMYCES BOULARDII) 200 MG P	8.8826	13.3278	-8.8878	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	09636	FLORATIL (SACCHAROMYCES BOULARDII) 200 MG P	4.4400	8.8851	-4.4451	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	09636	FLORATIL (SACCHAROMYCES BOULARDII) 200 MG P	4.4400	8.8851	-4.4451	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	27600	ONDANSETRONA 2 MG/ML 4 ML SI IM IV AP	81.1800	94.7100	-81.1800	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	19445	CLORETO DE POTASSIO 600 MG CA VO UN	1.4637	1.9474	-1.4574	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	05975	COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER	0.7739	0.8059	-0.7759	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	08664	ESPARADRAPO MICROPORE 50 X 10 CM CM	1.1320	1.1546	-0.8946	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	08664	ESPARADRAPO MICROPORE 50 X 10 CM CM	1.1064	1.1285	-0.8685	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1d6bbb4a00130e2e654e830fc9bae6a	ALEXANDRINA	12694224940	NULL	12694224940	05274	AMOXICILINA 500 MG + CLAVULANATO 125 MG CP	3.1700	3.1666	0.0033	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1d6bbb4a00130e2e654e830fc9bae6a	ALEXANDRINA	12694224940	NULL	12694224940	05274	AMOXICILINA 500 MG + CLAVULANATO 125 MG CP	3.1700	3.1666	0.0033	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1d6bbb4a00130e2e654e830fc9bae6a	ALEXANDRINA	12694224940	NULL	12694224940	05274	AMOXICILINA 500 MG + CLAVULANATO 125 MG CP	3.1700	3.1666	0.0033	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	000445	TAXA DE TRANSPORTE E INSTALACAO DE EQUIPAMENTO DE	NULL	0.0000	NULL	OPME INVALIDO	2201
Glosa Min	2018-10-03 00:00:00.000000	1084117	900c66260626ee704d2ca7bb91ae2f1c	MARIA	12705991543	NULL	12705991543	51584	ESPARADRAPO MICROPORE	NULL	0.0000	NULL	OPME INVALIDO	2201
Glosa Min	2018-10-03 00:00:00.000000	1084117	800720d33fe0defb6121e82dd216d044	JALMO	12786952647	NULL	12786952647	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	800720d33fe0defb6121e82dd216d044	JALMO	12786952647	NULL	12786952647	51241	AGULHA 123X45	0.0000	0.1900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	800720d33fe0defb6121e82dd216d044	JALMO	12786952647	NULL	12786952647	00757	CEFUROXIMA 750 MG + DIL. 6 ML PO IM IV FA	0.0000	26.1300	NULL	VALOR APRESENTADO A MAIOR	1705
Glosa Min	2018-10-03 00:00:00.000000	1084117	752c651cb4fd049e19c685f87fbe8bdc	EDUARDO	12765990646	NULL	12765990646	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.0000	0.6875	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	752c651cb4fd049e19c685f87fbe8bdc	EDUARDO	12765990646	NULL	12765990646	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.0000	0.6900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	752c651cb4fd049e19c685f87fbe8bdc	EDUARDO	12765990646	NULL	12765990646	53975	Hemifumarato De Quetiapina 25mg ? Cp	0.0000	1.2450	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	752c651cb4fd049e19c685f87fbe8bdc	EDUARDO	12765990646	NULL	12765990646	53975	Hemifumarato De Quetiapina 25mg ? Cp	0.0000	1.2500	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	752c651cb4fd049e19c685f87fbe8bdc	EDUARDO	12765990646	NULL	12765990646	53975	Hemifumarato De Quetiapina 25mg ? Cp	0.0000	1.2450	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12558131243	NULL	12558131243	52010341	Hérnia Discal - Tratamento Cirúrgico	0.0000	0.0000	NULL	COBRANCA DE HONORARIOS EM DUPLICIDADE	2607
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12558131243	NULL	12558131243	52010511	Fratura do Cóccix - Tratamento Cruento	0.0000	0.0000	NULL	COBRANCA DE HONORARIOS EM DUPLICIDADE	2607
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12558131243	NULL	12558131243	52010511	Fratura do Cóccix - Tratamento Cruento	0.0000	0.0000	NULL	COBRANCA DE HONORARIOS EM DUPLICIDADE	2607
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12558131243	NULL	12558131243	52010511	Fratura do Cóccix - Tratamento Cruento	0.0000	0.0000	NULL	COBRANCA DE HONORARIOS EM DUPLICIDADE	2607
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12558131243	NULL	12558131243	52010511	Fratura do Cóccix - Tratamento Cruento	0.0000	0.0000	NULL	COBRANCA DE HONORARIOS EM DUPLICIDADE	2607
Glosa Min	2018-10-03 00:00:00.000000	1084117	526685c1041cc1316e874a2e95e67e2e	JOSE	12696604949	NULL	12696604949	00169	SORO GLICOSADO 5% 500 ML SI IV BS	0.0000	5.1900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	526685c1041cc1316e874a2e95e67e2e	JOSE	12696604949	NULL	12696604949	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1760	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	526685c1041cc1316e874a2e95e67e2e	JOSE	12696604949	NULL	12696604949	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1760	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	526685c1041cc1316e874a2e95e67e2e	JOSE	12696604949	NULL	12696604949	00095	ABOCATH N 14 A 22 UN	0.0000	0.3200	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	11232	CLEXANE (ENOXAPARINA) 40 MG SI IV SC SE	0.0000	38.9400	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	11700	EQUIPO P/ BOMBA DE INFUSAO ENTERAL / PARENTERAL	0.0000	20.2800	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	11700	EQUIPO P/ BOMBA DE INFUSAO ENTERAL / PARENTERAL	0.0000	0.0000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.0000	0.0000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.0000	0.0000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.0000	0.0000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.0000	0.0000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.0000	0.0000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.0000	0.0000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.0000	0.0000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.0000	0.4000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.0000	0.4000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	51164	AGUA BIDESTILADA 500 ML	0.0000	6.4300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	51164	AGUA BIDESTILADA 500 ML	0.0000	6.4300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.0000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.0000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	51379	SERINGA DESC 05 ML UN	0.0000	0.1900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	51379	SERINGA DESC 05 ML UN	0.0000	0.1900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	51379	SERINGA DESC 05 ML UN	0.0000	0.1900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	51434	BECLOMETASONA 400 MCG / ML 2 ML SL IN FL	0.0000	4.4800	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	51434	BECLOMETASONA 400 MCG / ML 2 ML SL IN FL	0.0000	4.4800	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	51434	BECLOMETASONA 400 MCG / ML 2 ML SL IN FL	0.0000	4.4800	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	51708	Dieta Hipercalorica Hiperproteica Sem Fibras 1.5 kcal	0.0000	73.4000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	51708	Dieta Hipercalorica Hiperproteica Sem Fibras 1.5 kcal	0.0000	73.4000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	734612c551b837fa6a288126bac538d4	MARIA	12574536240	NULL	12574536240	00613	CLINDAMICINA 600 MG 4 ML SI IM IV AP	0.0000	13.0800	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	4e13adf421809cb755e1bdd80cc4efed	AGRIPINA	12385409142	NULL	12385409142	201005	TAXA DE SALA PORTE IV	0.0000	500.6800	NULL	VALOR APRESENTADO A MAIOR	1705
Glosa Min	2018-10-03 00:00:00.000000	1084117	4e13adf421809cb755e1bdd80cc4efed	AGRIPINA	12385409142	NULL	12385409142	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	4e13adf421809cb755e1bdd80cc4efed	AGRIPINA	12385409142	NULL	12385409142	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.0000	0.4000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	4e13adf421809cb755e1bdd80cc4efed	AGRIPINA	12385409142	NULL	12385409142	51379	SERINGA DESC 05 ML UN	0.0000	0.5800	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	4e13adf421809cb755e1bdd80cc4efed	AGRIPINA	12385409142	NULL	12385409142	00090	SERINGA DESC 20 ML UN	0.0000	0.5300	NULL	VALOR APRESENTADO A MAIOR	1705
Glosa Min	2018-10-03 00:00:00.000000	1084117	75bcd473a0dc7c7a6751499b38a4a034	JOAQUIM	12692852143	NULL	12692852143	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4075	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	75bcd473a0dc7c7a6751499b38a4a034	JOAQUIM	12692852143	NULL	12692852143	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4075	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	75bcd473a0dc7c7a6751499b38a4a034	JOAQUIM	12692852143	NULL	12692852143	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	75bcd473a0dc7c7a6751499b38a4a034	JOAQUIM	12692852143	NULL	12692852143	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4075	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	75bcd473a0dc7c7a6751499b38a4a034	JOAQUIM	12692852143	NULL	12692852143	01652	TRAMADOL 50 MG CP VO UN	0.0000	1.9272	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	75bcd473a0dc7c7a6751499b38a4a034	JOAQUIM	12692852143	NULL	12692852143	01652	TRAMADOL 50 MG CP VO UN	0.0000	1.9272	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	75bcd473a0dc7c7a6751499b38a4a034	JOAQUIM	12692852143	NULL	12692852143	01652	TRAMADOL 50 MG CP VO UN	0.0000	1.9272	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	75bcd473a0dc7c7a6751499b38a4a034	JOAQUIM	12692852143	NULL	12692852143	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.0000	0.6850	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	75bcd473a0dc7c7a6751499b38a4a034	JOAQUIM	12692852143	NULL	12692852143	04073	TRAMADOL 50 MG 1 ML SI IM IV AP	0.0000	4.1900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	75bcd473a0dc7c7a6751499b38a4a034	JOAQUIM	12692852143	NULL	12692852143	04073	TRAMADOL 50 MG 1 ML SI IM IV AP	0.0000	4.1900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	75bcd473a0dc7c7a6751499b38a4a034	JOAQUIM	12692852143	NULL	12692852143	04073	TRAMADOL 50 MG 1 ML SI IM IV AP	0.0000	4.1900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	75bcd473a0dc7c7a6751499b38a4a034	JOAQUIM	12692852143	NULL	12692852143	51710	CLORETO DE POTASSIO 15% 10 ML SI IV AP	0.0000	0.6850	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00124	LUVA CIRURGICA UN	0.0000	1.4475	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00124	LUVA CIRURGICA UN	0.0000	1.4475	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	24082	BROMOPRIDA 5 MG/ML 2 ML SI IM IV AP	0.0000	2.7300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	26981	SORO FISIOLOGICO 0,9% 10 ML SI IV AP	0.0000	0.9600	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	26981	SORO FISIOLOGICO 0,9% 10 ML SI IV AP	0.0000	0.9600	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	26981	SORO FISIOLOGICO 0,9% 10 ML SI IV AP	0.0000	0.9600	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	03280	CLOREXIDINA 2 % ST TP ML	0.0000	0.5300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	03280	CLOREXIDINA 2 % ST TP ML	0.0000	0.5300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	03280	CLOREXIDINA 2 % ST TP ML	0.0000	0.5300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.0000	0.6875	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.0000	0.6875	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00487	RANITIDINA 25 MG/ML 2 ML SI IM IV AP	0.0000	0.9300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00487	RANITIDINA 25 MG/ML 2 ML SI IM IV AP	0.0000	0.9300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	54756	HIDANTAL	0.0000	0.1864	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	55795	FOSFATO DE POTASSIO 2 MEQ/ML 10 ML SI IV AP	0.0000	3.0200	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00796	FLORATIL (SACCHAROMYCES BOULARDII) 200 MG PO VO	0.0000	4.4400	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12631509346	NULL	12631509346	00796	FLORATIL (SACCHAROMYCES BOULARDII) 200 MG PO VO	0.0000	4.4400	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4088	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4088	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4088	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4088	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4088	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4088	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4088	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4088	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4088	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4088	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4088	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	28010337	Cálcio Ionizável	0.0000	0.0000	NULL	EXAME NAO AUTORIZADO	2707
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.0000	0.6872	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.0000	0.6872	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.0000	0.6872	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.0000	0.6872	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.0000	0.6872	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.0000	0.6872	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.0000	0.6872	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.0000	0.6872	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.0000	0.6872	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.0000	0.6900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1800	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1766	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1766	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a3bfb82253860b1398994277c29a8da8	SEBASTIAO	12269818544	NULL	12269818544	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1766	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4070	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	51584	ESPARADRAPO MICROPORE	0.0000	0.2560	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	51584	ESPARADRAPO MICROPORE	0.0000	0.2560	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	51584	ESPARADRAPO MICROPORE	0.0000	0.2560	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	51584	ESPARADRAPO MICROPORE	0.0000	0.2560	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	51584	ESPARADRAPO MICROPORE	0.0000	0.2560	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	51584	ESPARADRAPO MICROPORE	0.0000	0.2560	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	51584	ESPARADRAPO MICROPORE	0.0000	0.2560	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	52303	NOREPINEFRINA 2 MG/ML 4 ML SI IV AP	0.0000	9.4962	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	52303	NOREPINEFRINA 2 MG/ML 4 ML SI IV AP	0.0000	85.4700	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	9dfc31860f2d2ae957debc955e9c1025	VALDIR	12693932848	NULL	12693932848	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	cd2840524be5a3f1d0939f241e24f32b	MARIA	12705908340	NULL	12705908340	11232	CLEXANE (ENOXAPARINA) 40 MG SI IV SC SE	0.0000	36.8000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	cd2840524be5a3f1d0939f241e24f32b	MARIA	12705908340	NULL	12705908340	00181	SULFATO DE MAGNESIO 100 MG/ML 10 ML SI IM IV	0.0000	0.9467	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	cd2840524be5a3f1d0939f241e24f32b	MARIA	12705908340	NULL	12705908340	00181	SULFATO DE MAGNESIO 100 MG/ML 10 ML SI IM IV	0.0000	0.9467	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	cd2840524be5a3f1d0939f241e24f32b	MARIA	12705908340	NULL	12705908340	00184	CLORETO DE POTASSIO 10% 10 ML SI IV AP	0.0000	0.2967	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	cd2840524be5a3f1d0939f241e24f32b	MARIA	12705908340	NULL	12705908340	25040014	Fisioterapia Respiratória - em Doente Clínico Internado	0.0000	0.0000	NULL	EXAME SEM REGISTRO DE EXECUCAO	2703
Glosa Min	2018-10-03 00:00:00.000000	1084117	cd2840524be5a3f1d0939f241e24f32b	MARIA	12705908340	NULL	12705908340	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	cd2840524be5a3f1d0939f241e24f32b	MARIA	12705908340	NULL	12705908340	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	cd2840524be5a3f1d0939f241e24f32b	MARIA	12705908340	NULL	12705908340	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	cd2840524be5a3f1d0939f241e24f32b	MARIA	12705908340	NULL	12705908340	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12550571048	NULL	12550571048	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1775	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12550571048	NULL	12550571048	00090	SERINGA DESC 20 ML UN	0.0000	0.5379	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12550571048	NULL	12550571048	00090	SERINGA DESC 20 ML UN	0.0000	0.5379	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12550571048	NULL	12550571048	00090	SERINGA DESC 20 ML UN	0.0000	0.5379	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12550571048	NULL	12550571048	00090	SERINGA DESC 20 ML UN	0.0000	0.5379	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	ab92e84cfdb4f371201a28fa853db1be	IARA	12550571048	NULL	12550571048	00090	SERINGA DESC 20 ML UN	0.0000	0.5379	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	9ffbbf7340bbd65e9e3baa9406d027f3	MARCO	12261811645	NULL	12261811645	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	9ffbbf7340bbd65e9e3baa9406d027f3	MARCO	12261811645	NULL	12261811645	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	9ffbbf7340bbd65e9e3baa9406d027f3	MARCO	12261811645	NULL	12261811645	01611	CLORETO DE POTASSIO 600 MG CA VO UN	0.0000	0.4867	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	9ffbbf7340bbd65e9e3baa9406d027f3	MARCO	12261811645	NULL	12261811645	01611	CLORETO DE POTASSIO 600 MG CA VO UN	0.0000	0.4867	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	9ffbbf7340bbd65e9e3baa9406d027f3	MARCO	12261811645	NULL	12261811645	01611	CLORETO DE POTASSIO 600 MG CA VO UN	0.0000	0.4867	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	9ffbbf7340bbd65e9e3baa9406d027f3	MARCO	12261811645	NULL	12261811645	01611	CLORETO DE POTASSIO 600 MG CA VO UN	0.0000	0.4867	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	9ffbbf7340bbd65e9e3baa9406d027f3	MARCO	12261811645	NULL	12261811645	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.0000	0.8078	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	9ffbbf7340bbd65e9e3baa9406d027f3	MARCO	12261811645	NULL	12261811645	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.0000	0.8078	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	9ffbbf7340bbd65e9e3baa9406d027f3	MARCO	12261811645	NULL	12261811645	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.0000	0.8078	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	9ffbbf7340bbd65e9e3baa9406d027f3	MARCO	12261811645	NULL	12261811645	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.0000	0.8078	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	9ffbbf7340bbd65e9e3baa9406d027f3	MARCO	12261811645	NULL	12261811645	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.0000	0.8078	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	9ffbbf7340bbd65e9e3baa9406d027f3	MARCO	12261811645	NULL	12261811645	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1773	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	9ffbbf7340bbd65e9e3baa9406d027f3	MARCO	12261811645	NULL	12261811645	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1773	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	9ffbbf7340bbd65e9e3baa9406d027f3	MARCO	12261811645	NULL	12261811645	00090	SERINGA DESC 20 ML UN	0.0000	0.5376	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	9ffbbf7340bbd65e9e3baa9406d027f3	MARCO	12261811645	NULL	12261811645	00090	SERINGA DESC 20 ML UN	0.0000	0.5376	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	9ffbbf7340bbd65e9e3baa9406d027f3	MARCO	12261811645	NULL	12261811645	00090	SERINGA DESC 20 ML UN	0.0000	0.5376	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4094	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4094	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	01496	FENITOINA 50 MG/ML 5 ML SI IM IV AP	0.0000	2.3400	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	01496	FENITOINA 50 MG/ML 5 ML SI IM IV AP	0.0000	2.3400	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	01496	FENITOINA 50 MG/ML 5 ML SI IM IV AP	0.0000	2.3400	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	00165	DEXAMETASONA 4 MG/ML 2,5 ML SI IM IV FA	0.0000	3.4200	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	02246	HIDROCORTISONA 100 MG PO IM IV FA	0.0000	2.8300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	26981	SORO FISIOLOGICO 0,9% 10 ML SI IV AP	0.0000	0.4800	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	26981	SORO FISIOLOGICO 0,9% 10 ML SI IV AP	0.0000	0.9600	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	26981	SORO FISIOLOGICO 0,9% 10 ML SI IV AP	0.0000	0.9600	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	26981	SORO FISIOLOGICO 0,9% 10 ML SI IV AP	0.0000	0.9600	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	52392	SONDA DE ASPIRAÇAO TRAQUEAL C/ VALVULA UN	0.0000	0.9352	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	09070	ACETILCISTEINA 600MG PO VO SA	0.0000	3.4950	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	09070	ACETILCISTEINA 600MG PO VO SA	0.0000	3.4950	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	730a54d9cef9c3809a9e601b24d92900	MIGUEL	12748953246	NULL	12748953246	00090	SERINGA DESC 20 ML UN	0.0000	0.5300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	15f461c0ca379f375bd9f8b18fbb101a	ANA	12753753845	NULL	12753753845	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR APRESENTADO A MAIOR	1705
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	01229	FLEET ENEMA (FOSFATO DE SODIO DIBASICO + FOSFATO	0.0000	1.1716	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4072	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4072	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4072	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4072	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4072	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4072	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4072	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4072	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4072	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4072	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4072	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4072	NULL	VALOR APRESENTADO A MAIOR	1705
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4072	NULL	VALOR APRESENTADO A MAIOR	1705
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4072	NULL	COBRANCA DE MEDICAMENTO EM QUANTIDADE INCOMPATIVEL COM A PERMANENCIA	2107
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4072	NULL	COBRANCA DE MEDICAMENTO EM QUANTIDADE INCOMPATIVEL COM A PERMANENCIA	2107
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4072	NULL	VALOR APRESENTADO A MAIOR	1705
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00184	CLORETO DE POTASSIO 10% 10 ML SI IV AP	0.0000	0.5900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00184	CLORETO DE POTASSIO 10% 10 ML SI IV AP	0.0000	0.5900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00184	CLORETO DE POTASSIO 10% 10 ML SI IV AP	0.0000	0.5900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	02355	AMOXICILINA 1 G + CLAVULANATO 200 MG + DIL. 10 ML	0.0000	36.4667	NULL	COBRANCA DE MEDICAMENTO EM QUANTIDADE INCOMPATIVEL COM A PERMANENCIA	2107
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00090	SERINGA DESC 20 ML UN	0.0000	0.5367	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00090	SERINGA DESC 20 ML UN	0.0000	0.5367	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00090	SERINGA DESC 20 ML UN	0.0000	0.5367	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3a7b06385f8e5076d58a2b80b69d3691	MARIA	12607395840	NULL	12607395840	00090	SERINGA DESC 20 ML UN	0.0000	0.5367	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	2e6b6f291f2df9beb1fbda6028678909	ANNA	12463693448	NULL	12463693448	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	2e6b6f291f2df9beb1fbda6028678909	ANNA	12463693448	NULL	12463693448	09070	ACETILCISTEINA 600MG PO VO SA	0.0000	3.5000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	2e6b6f291f2df9beb1fbda6028678909	ANNA	12463693448	NULL	12463693448	09070	ACETILCISTEINA 600MG PO VO SA	0.0000	3.5000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	11325	EQUIPO MACRO-GOTAS FLEXIVEL C/ INJETOR LATERAL UN	0.0000	1.5900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00124	LUVA CIRURGICA UN	0.0000	1.4484	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00124	LUVA CIRURGICA UN	0.0000	1.4478	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00124	LUVA CIRURGICA UN	0.0000	1.4478	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.0000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.0000	0.6871	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.0000	0.6871	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.0000	0.6871	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	35382	COMPRESSAS DE GASES 7.5 X7,5 (11 FIOS ESTERIL) UN	0.0000	0.3000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	35382	COMPRESSAS DE GASES 7.5 X7,5 (11 FIOS ESTERIL) UN	0.0000	0.0000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00487	RANITIDINA 25 MG/ML 2 ML SI IM IV AP	0.0000	0.9300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00487	RANITIDINA 25 MG/ML 2 ML SI IM IV AP	0.0000	0.9300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00487	RANITIDINA 25 MG/ML 2 ML SI IM IV AP	0.0000	0.9300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00487	RANITIDINA 25 MG/ML 2 ML SI IM IV AP	0.0000	0.9300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00487	RANITIDINA 25 MG/ML 2 ML SI IM IV AP	0.0000	0.9300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00487	RANITIDINA 25 MG/ML 2 ML SI IM IV AP	0.0000	0.9300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00487	RANITIDINA 25 MG/ML 2 ML SI IM IV AP	0.0000	0.9300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.0000	0.4000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.0000	0.4000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.0000	0.4000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.0000	0.4000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.0000	0.4000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.0000	0.4000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.0000	0.4000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.0000	0.4000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1784	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	51649	ALCOOL ETILICO 70 % ST TP ML	0.0000	0.0300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00090	SERINGA DESC 20 ML UN	0.0000	0.5375	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00090	SERINGA DESC 20 ML UN	0.0000	0.5375	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00090	SERINGA DESC 20 ML UN	0.0000	0.5375	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00090	SERINGA DESC 20 ML UN	0.0000	0.5375	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00090	SERINGA DESC 20 ML UN	0.0000	0.5375	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00090	SERINGA DESC 20 ML UN	0.0000	0.5400	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00090	SERINGA DESC 20 ML UN	0.0000	0.5400	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00090	SERINGA DESC 20 ML UN	0.0000	0.5375	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00090	SERINGA DESC 20 ML UN	0.0000	0.5375	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00090	SERINGA DESC 20 ML UN	0.0000	0.5375	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	3bbfe282a7573b8ea1e0acb45985f346	FERNANDO	12660127044	NULL	12660127044	00090	SERINGA DESC 20 ML UN	0.0000	0.5375	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	09586cdd4dbbc5a8f142ad1eff19fbe6	VALDECI	12697562440	NULL	12697562440	103001	DIARIA DE U.T.I. UNIDADE DE TERAPIA INTENSIVA	0.0000	1419.1100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	09586cdd4dbbc5a8f142ad1eff19fbe6	VALDECI	12697562440	NULL	12697562440	000441	TAXA DE DELEUCOTIZAÇÃO	0.0000	0.0000	NULL	COBRANCA DE OUTRAS TAXAS ASSOCIADAS/INCLUSAS NA COBRANCA DA TAXA DE SALA PREVISTA	2404
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1965b0cdebe9017c3397c8641147759	JOSE	12705413746	NULL	12705413746	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1965b0cdebe9017c3397c8641147759	JOSE	12705413746	NULL	12705413746	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.0000	0.8074	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1965b0cdebe9017c3397c8641147759	JOSE	12705413746	NULL	12705413746	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.0000	0.8074	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1965b0cdebe9017c3397c8641147759	JOSE	12705413746	NULL	12705413746	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.0000	0.8074	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1965b0cdebe9017c3397c8641147759	JOSE	12705413746	NULL	12705413746	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1775	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1965b0cdebe9017c3397c8641147759	JOSE	12705413746	NULL	12705413746	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1775	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1965b0cdebe9017c3397c8641147759	JOSE	12705413746	NULL	12705413746	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1775	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1965b0cdebe9017c3397c8641147759	JOSE	12705413746	NULL	12705413746	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1775	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1965b0cdebe9017c3397c8641147759	JOSE	12705413746	NULL	12705413746	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1775	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1965b0cdebe9017c3397c8641147759	JOSE	12705413746	NULL	12705413746	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1775	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1965b0cdebe9017c3397c8641147759	JOSE	12705413746	NULL	12705413746	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1775	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1965b0cdebe9017c3397c8641147759	JOSE	12705413746	NULL	12705413746	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1775	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1965b0cdebe9017c3397c8641147759	JOSE	12705413746	NULL	12705413746	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1775	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1965b0cdebe9017c3397c8641147759	JOSE	12705413746	NULL	12705413746	51584	ESPARADRAPO MICROPORE	0.0000	0.0000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1965b0cdebe9017c3397c8641147759	JOSE	12705413746	NULL	12705413746	51671	REPARIL (ESCINA + DIETILAMONIO) GL TP GR	0.0000	0.0000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1965b0cdebe9017c3397c8641147759	JOSE	12705413746	NULL	12705413746	00090	SERINGA DESC 20 ML UN	0.0000	0.5375	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1965b0cdebe9017c3397c8641147759	JOSE	12705413746	NULL	12705413746	00090	SERINGA DESC 20 ML UN	0.0000	0.5375	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1965b0cdebe9017c3397c8641147759	JOSE	12705413746	NULL	12705413746	00090	SERINGA DESC 20 ML UN	0.0000	0.5375	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1965b0cdebe9017c3397c8641147759	JOSE	12705413746	NULL	12705413746	00090	SERINGA DESC 20 ML UN	0.0000	0.5375	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1965b0cdebe9017c3397c8641147759	JOSE	12705413746	NULL	12705413746	00090	SERINGA DESC 20 ML UN	0.0000	0.5375	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1965b0cdebe9017c3397c8641147759	JOSE	12705413746	NULL	12705413746	00090	SERINGA DESC 20 ML UN	0.0000	0.5375	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	e1965b0cdebe9017c3397c8641147759	JOSE	12705413746	NULL	12705413746	00090	SERINGA DESC 20 ML UN	0.0000	0.5375	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	dd6f8d6c53ffe9bfd3aa9590ba500cc8	ILDA	12751932542	NULL	12751932542	52010015	Artrodese da Coluna Vertebral Via Posterior	0.0000	498.2200	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a39fe8b0276da428395df4da4f2b1537	JOSE	12442708440	NULL	12442708440	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a39fe8b0276da428395df4da4f2b1537	JOSE	12442708440	NULL	12442708440	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a39fe8b0276da428395df4da4f2b1537	JOSE	12442708440	NULL	12442708440	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a39fe8b0276da428395df4da4f2b1537	JOSE	12442708440	NULL	12442708440	20691	HIDROCORTISONA 100 MG PO IM IV FA	0.0000	2.8300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a39fe8b0276da428395df4da4f2b1537	JOSE	12442708440	NULL	12442708440	20691	HIDROCORTISONA 100 MG PO IM IV FA	0.0000	2.8300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a39fe8b0276da428395df4da4f2b1537	JOSE	12442708440	NULL	12442708440	26981	SORO FISIOLOGICO 0,9% 10 ML SI IV AP	0.0000	0.1400	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a39fe8b0276da428395df4da4f2b1537	JOSE	12442708440	NULL	12442708440	26981	SORO FISIOLOGICO 0,9% 10 ML SI IV AP	0.0000	0.1400	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a39fe8b0276da428395df4da4f2b1537	JOSE	12442708440	NULL	12442708440	29020166	Nebulização Simples com Broncodilatador	0.0000	1.1700	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a39fe8b0276da428395df4da4f2b1537	JOSE	12442708440	NULL	12442708440	29020166	Nebulização Simples com Broncodilatador	0.0000	2.3400	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a39fe8b0276da428395df4da4f2b1537	JOSE	12442708440	NULL	12442708440	29020166	Nebulização Simples com Broncodilatador	0.0000	3.5100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a39fe8b0276da428395df4da4f2b1537	JOSE	12442708440	NULL	12442708440	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1765	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a39fe8b0276da428395df4da4f2b1537	JOSE	12442708440	NULL	12442708440	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1765	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a39fe8b0276da428395df4da4f2b1537	JOSE	12442708440	NULL	12442708440	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1765	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a39fe8b0276da428395df4da4f2b1537	JOSE	12442708440	NULL	12442708440	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1765	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a39fe8b0276da428395df4da4f2b1537	JOSE	12442708440	NULL	12442708440	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1765	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a39fe8b0276da428395df4da4f2b1537	JOSE	12442708440	NULL	12442708440	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1765	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a39fe8b0276da428395df4da4f2b1537	JOSE	12442708440	NULL	12442708440	51241	AGULHA 123X45	0.0000	0.1900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a39fe8b0276da428395df4da4f2b1537	JOSE	12442708440	NULL	12442708440	51241	AGULHA 123X45	0.0000	0.1900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a39fe8b0276da428395df4da4f2b1537	JOSE	12442708440	NULL	12442708440	51659	FENOTEROL 2 MG/ML 10 ML AE IN DS	0.0000	0.2567	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a39fe8b0276da428395df4da4f2b1537	JOSE	12442708440	NULL	12442708440	51659	FENOTEROL 2 MG/ML 10 ML AE IN DS	0.0000	0.2567	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a39fe8b0276da428395df4da4f2b1537	JOSE	12442708440	NULL	12442708440	00090	SERINGA DESC 20 ML UN	0.0000	0.5373	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a39fe8b0276da428395df4da4f2b1537	JOSE	12442708440	NULL	12442708440	00090	SERINGA DESC 20 ML UN	0.0000	0.5373	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	a39fe8b0276da428395df4da4f2b1537	JOSE	12442708440	NULL	12442708440	00098	ABOCATH N 14 A 22 UN	0.0000	3.7700	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	61e4786d45edfdbf19b77fb2c6ce6b9c	REINALDO	12754482747	NULL	12754482747	00172	SORO FISIOLOGICO 0,9% 500 ML SI IV BS	0.0000	4.7300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	61e4786d45edfdbf19b77fb2c6ce6b9c	REINALDO	12754482747	NULL	12754482747	30010136	Quimioterapia Sistêmica do 2o. ao 7o. Dia Subseqüente na Semana, por Dia de Tratamento	0.0000	0.2500	NULL	COBRANCA DE HONORARIOS EM DUPLICIDADE	2607
Glosa Min	2018-10-03 00:00:00.000000	1084117	61e4786d45edfdbf19b77fb2c6ce6b9c	REINALDO	12754482747	NULL	12754482747	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	61e4786d45edfdbf19b77fb2c6ce6b9c	REINALDO	12754482747	NULL	12754482747	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	61e4786d45edfdbf19b77fb2c6ce6b9c	REINALDO	12754482747	NULL	12754482747	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.0000	0.6900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	61e4786d45edfdbf19b77fb2c6ce6b9c	REINALDO	12754482747	NULL	12754482747	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.0000	0.6900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	61e4786d45edfdbf19b77fb2c6ce6b9c	REINALDO	12754482747	NULL	12754482747	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.0000	0.6900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	61e4786d45edfdbf19b77fb2c6ce6b9c	REINALDO	12754482747	NULL	12754482747	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	102001	DIARIA DE APARTAMENTO	0.0000	288.8880	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	102001	DIARIA DE APARTAMENTO	0.0000	288.8900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	102001	DIARIA DE APARTAMENTO	0.0000	288.8900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4072	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4072	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4072	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	51649	ALCOOL ETILICO 70 % ST TP ML	0.0000	0.0600	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	00090	SERINGA DESC 20 ML UN	0.0000	0.5371	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	00090	SERINGA DESC 20 ML UN	0.0000	0.5371	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	c72cebd9d0b9e675b9c451a2b9dc0207	LUZIA	12708633242	NULL	12708633242	00090	SERINGA DESC 20 ML UN	0.0000	0.5371	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	081fdadb830fb547e83c43fabdb88372	ELZA	12377335349	NULL	12377335349	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	081fdadb830fb547e83c43fabdb88372	ELZA	12377335349	NULL	12377335349	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	081fdadb830fb547e83c43fabdb88372	ELZA	12377335349	NULL	12377335349	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	081fdadb830fb547e83c43fabdb88372	ELZA	12377335349	NULL	12377335349	01611	CLORETO DE POTASSIO 600 MG CA VO UN	0.0000	0.4900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	081fdadb830fb547e83c43fabdb88372	ELZA	12377335349	NULL	12377335349	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1800	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	081fdadb830fb547e83c43fabdb88372	ELZA	12377335349	NULL	12377335349	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1800	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	081fdadb830fb547e83c43fabdb88372	ELZA	12377335349	NULL	12377335349	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1800	NULL	PAGO CONFORME RELATORIO DE AUDITORIA EXTERNA ― CONTA INICIAL	1717
Glosa Min	2018-10-03 00:00:00.000000	1084117	081fdadb830fb547e83c43fabdb88372	ELZA	12377335349	NULL	12377335349	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1800	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.0000	0.6860	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.0000	0.6860	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.0000	0.6860	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.0000	0.6860	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	000451	TAXA DE ALIMENTACAO PARA ACOMPANHANTES - 3 REFEICO	0.0000	0.0000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	51379	SERINGA DESC 05 ML UN	0.0000	0.1900	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	51379	SERINGA DESC 05 ML UN	0.0000	0.1900	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	51379	SERINGA DESC 05 ML UN	0.0000	0.1900	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	51379	SERINGA DESC 05 ML UN	0.0000	0.1900	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	51379	SERINGA DESC 05 ML UN	0.0000	0.1900	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	aa7c02a1c41a7519f424396a5c602643	JOAO	12624315048	NULL	12624315048	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	345c226bfea274af1372d41b0305a6c8	ALTINO	12720257940	NULL	12720257940	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	4668d2494ed6c4b2d18be299efcb26a2	JOAO	12469689344	NULL	12469689344	51584	ESPARADRAPO MICROPORE	NULL	0.0000	NULL	OPME INVALIDO	2201
Glosa Min	2018-10-03 00:00:00.000000	1084117	4668d2494ed6c4b2d18be299efcb26a2	JOAO	12469689344	NULL	12469689344	56261	CLOREXIDINA 2 % ST TP ML DEGERMANTE	NULL	0.0000	NULL	OPME INVALIDO	2201
Glosa Min	2018-10-03 00:00:00.000000	1084117	dd486d36a88cfef0b44fe652638a0164	DELFINA	12660326244	NULL	12660326244	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	dd486d36a88cfef0b44fe652638a0164	DELFINA	12660326244	NULL	12660326244	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	dd486d36a88cfef0b44fe652638a0164	DELFINA	12660326244	NULL	12660326244	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	dd486d36a88cfef0b44fe652638a0164	DELFINA	12660326244	NULL	12660326244	00069	SERINGA DESC 10 ML UN	0.0000	0.3300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	dd486d36a88cfef0b44fe652638a0164	DELFINA	12660326244	NULL	12660326244	00090	SERINGA DESC 20 ML UN	0.0000	0.5400	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	dd486d36a88cfef0b44fe652638a0164	DELFINA	12660326244	NULL	12660326244	00090	SERINGA DESC 20 ML UN	0.0000	0.5400	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	13812	BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS	0.0000	3.4100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	01652	TRAMADOL 50 MG CP VO UN	0.0000	1.9300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	01652	TRAMADOL 50 MG CP VO UN	0.0000	1.9300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	01652	TRAMADOL 50 MG CP VO UN	0.0000	1.9300	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	00033	AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN	0.0000	0.1000	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.0000	0.6900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.0000	0.6900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.0000	0.6900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.0000	0.6900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	00342	DIPIRONA 500 MG/ML 2 ML SI IM IV AP	0.0000	0.6900	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	35382	COMPRESSAS DE GASES 7.5 X7,5 (11 FIOS ESTERIL) UN	0.0000	0.3000	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.0000	0.8100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.0000	0.8100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.0000	0.8100	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	51230	AGULHA DESC 30 X 7 - 40X12 UN	0.0000	0.1800	NULL	VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA	1714
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	51588	ESPARADRAPO MICROPORE 50 X 10 CM CM	0.0000	0.7700	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	cf0948b768ab5bb62ad5d1e892021139	ANTONIO	12725005347	NULL	12725005347	51588	ESPARADRAPO MICROPORE 50 X 10 CM CM	0.0000	0.7700	NULL	MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU	0306
Glosa Min	2018-10-03 00:00:00.000000	1084117	610c198ec4c064687cf0524f147d3aed	ROBERTO	12748814743	NULL	12748814743	16322	BENZILPENICILINA POTASSICA CRIST. 5.000.000	8.0700	8.0683	0.0017	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	51378	SERINGA DESC 03 ML UN	0.1500	0.0600	0.0900	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	51378	SERINGA DESC 03 ML UN	0.1500	0.0600	0.0900	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	53932	ALPRAZOLAM 0,25 MG CP VO UN	0.2600	0.1100	0.1500	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00091	SERINGA DESC 01 ML (INSULINA) UN	0.3100	0.1300	0.1800	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00127	LUVA DE PROCEDIMENTO UNIDADE UN	0.3300	0.1300	0.2000	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	00127	LUVA DE PROCEDIMENTO UNIDADE UN	0.3300	0.1300	0.2000	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.4000	0.1600	0.2400	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.4000	0.1600	0.2400	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.4000	0.1600	0.2400	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.4000	0.1600	0.2400	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.4000	0.1600	0.2400	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.4000	0.1600	0.2400	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.4000	0.1600	0.2400	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.4000	0.1600	0.2400	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	51162	AGUA BIDESTILADA 10 ML SI IM IV AP	0.4000	0.1600	0.2400	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	54687	IODOPOVIDONA SD TP ML	0.4000	0.1600	0.2400	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	880e253fcba3461dbf3e0fdc52428cce	DIVINA	12633927040	NULL	12633927040	07802	PIPERACILINA 4 G + TAZOBACTAM 500 MG PO IV FA	83.4500	32.5900	50.8600	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	01081197	5125859e8d2860b83822c41756a9b5bf	ESMERALDA	12734516820	NULL	12734516820...	203001	TAXA DE BOX HORA 1 CICLO	0.0000	0.0000	NULL	TAXA / ALUGUEL INVALIDO	2401
Glosa Min	2018-10-03 00:00:00.000000	01081197	e0b1f77dc9cff210f2fbead99c7ba4d4	MARCIO	12790052920	NULL	12790052920	00171	SORO FISIOLOGICO 0,9% 250 ML SI IV BS	NULL	0.0000	NULL	OPME INVALIDO	2201
Glosa Min	2018-10-03 00:00:00.000000	1084117	16b1e9f62f247f02ad5cac910ee15b4e	BERCHOLINA	12631612848	NULL	12631612848	00171	SORO FISIOLOGICO 0,9% 250 ML SI IV BS	3.9400	3.7600	0.1800	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	16b1e9f62f247f02ad5cac910ee15b4e	BERCHOLINA	12631612848	NULL	12631612848	04073	TRAMADOL 50 MG 1 ML SI IM IV AP	4.1900	4.0000	0.1900	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	16b1e9f62f247f02ad5cac910ee15b4e	BERCHOLINA	12631612848	NULL	12631612848	04073	TRAMADOL 50 MG 1 ML SI IM IV AP	4.1900	4.0000	0.1900	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	16b1e9f62f247f02ad5cac910ee15b4e	BERCHOLINA	12631612848	NULL	12631612848	04073	TRAMADOL 50 MG 1 ML SI IM IV AP	4.1900	4.0000	0.1900	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	16b1e9f62f247f02ad5cac910ee15b4e	BERCHOLINA	12631612848	NULL	12631612848	04073	TRAMADOL 50 MG 1 ML SI IM IV AP	4.1900	3.9900	0.2000	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	16b1e9f62f247f02ad5cac910ee15b4e	BERCHOLINA	12631612848	NULL	12631612848	04073	TRAMADOL 50 MG 1 ML SI IM IV AP	4.1900	3.9900	0.2000	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	16b1e9f62f247f02ad5cac910ee15b4e	BERCHOLINA	12631612848	NULL	12631612848	04073	TRAMADOL 50 MG 1 ML SI IM IV AP	4.1900	3.9900	0.2000	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	16b1e9f62f247f02ad5cac910ee15b4e	BERCHOLINA	12631612848	NULL	12631612848	22421	PIPERACILINA 2 G + TAZOBACTAM 250 MG 30 ML PO IV	55.3400	52.7400	2.6000	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	16b1e9f62f247f02ad5cac910ee15b4e	BERCHOLINA	12631612848	NULL	12631612848	22421	PIPERACILINA 2 G + TAZOBACTAM 250 MG 30 ML PO IV	55.3400	52.7400	2.6000	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	16b1e9f62f247f02ad5cac910ee15b4e	BERCHOLINA	12631612848	NULL	12631612848	22421	PIPERACILINA 2 G + TAZOBACTAM 250 MG 30 ML PO IV	55.3400	52.7400	2.6000	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	16b1e9f62f247f02ad5cac910ee15b4e	BERCHOLINA	12631612848	NULL	12631612848	22421	PIPERACILINA 2 G + TAZOBACTAM 250 MG 30 ML PO IV	55.3400	52.7400	2.6000	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	16b1e9f62f247f02ad5cac910ee15b4e	BERCHOLINA	12631612848	NULL	12631612848	22421	PIPERACILINA 2 G + TAZOBACTAM 250 MG 30 ML PO IV	55.3400	52.7400	2.6000	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	16b1e9f62f247f02ad5cac910ee15b4e	BERCHOLINA	12631612848	NULL	12631612848	20080	LINEZOLIDA 2 MG/ML 300 ML SI IV BS	174.9800	166.7800	8.2000	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	1084117	16b1e9f62f247f02ad5cac910ee15b4e	BERCHOLINA	12631612848	NULL	12631612848	20080	LINEZOLIDA 2 MG/ML 300 ML SI IV BS	174.9800	166.7800	8.2000	ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO	7701
Glosa Min	2018-10-03 00:00:00.000000	01081195	335f5319bf8629a6efcb92037294fea8	JOSE	12820840018	NULL	12820840018	00010014	CONSULTA EM CONSULTORIO MEDICO	0.0000	50.0000	NULL	ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO	7700